NHI no solution to SA’s poor health system, says H Suzman Foundation

The proposed National Health Insurance (NHI) is a funding and payment mechanism that will be superimposed on the private and public health sectors, which are badly functioning “components”.

This according to the Helen Suzman Foundation which said nowhere in the NHI Bill was it explained how it would transform the poorly performing healthcare sectors to provide better quality services.

The foundation presented its submission on the bill during parliamentary hearings on Wednesday.

Its legal counsellor, Anton van Dalsen, said the government had not provided any estimates for implementing the NHI.

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“Details provided in the memorandum attached to the NHI Bill under the heading ‘financial implications for the state’ only provide estimates of a few items of preparatory costs.

“It is inconceivable that a project of this magnitude would be seriously considered, let alone implemented, in the private sector without a comprehensive feasibility study, including various scenarios to indicate what the associated costs would be for different levels of care.”

Van Dalsen added it would be logical for estimated costs to be provided for at least three scenarios.

According to him, these scenarios would include if the NHI was to cover only basic services, intermediate level of cover and if it was to cover all healthcare costs.

“No such feasibility study has been completed, and no cost estimates of this nature are available.

“With 60 million potential users, about 220 000 healthcare practitioners and a multitude of public and private healthcare facilities, any institution that manages a payment and quality control system to cover all of these has a massive administrative task, requiring an adequate number of competent workers and experienced managers.

“This very substantial administrative structure has to be started from scratch. No details are available on its planning and progress,” Van Dalsen said.

The CEO of the FW de Klerk Foundation, advocate Jacques du Preez, said an apolitical solution was needed to fix the healthcare system.

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“The foundation does not believe that the proposed NHI fund is the only means to achieve this noble goal. The urgent need to find workable solutions to address the stark inequality in healthcare services and to achieve universal health coverage in South Africa cannot and should not hinge on the feasibility of the NHI fund.

“In addition to the vagueness of several crucial provisions of the NHI Bill, one must also ask to what extent is the public able to engage meaningfully with the provisions of the NHI Bill, considering the lack of critical information provided on its implications,” Du Preez added.

In its submission, the Independent Community Pharmacy Association recommended that pharmacists be included in the definition of “primary healthcare.”

“As we strive to achieve one healthcare system, we also recommend the removal of the reference to the public health sector and private health sector,” part of its submission read.