Govt will ‘bulldoze’ NHI Bill through parliament, ‘brushing aside all concerns’

Taxpayers and members of medical aids are in for a shock: the controversial National Health Insurance (NHI) will sting you twice… you will lose current medical coverage tax credits and face a surcharge on top of the taxes you already pay.

The NHI Bill – being debated in parliament and which goes to a vote tomorrow – is designed to pool funds together to provide universal healthcare through taxpayers.

Nearly nine million South Africans are members of a medical aid, according to the latest annual report from the Council of Medical Schemes.

Objections

The Bill stated government would levy an extra tax on citizens’ personal income tax and use the money it will save by not giving tax credits for being a member of a medical scheme.

“The money referred must be appropriated from money collected and in accordance with social solidarity in respect of general tax revenue, including the shifting [of] funds from the provincial equitable share and conditional grants into the fund,” the proposed Bill states.

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It included the reallocation of funding “for medical scheme tax credits paid to various medical schemes towards the funding of National Health Insurance, payroll tax (employer and employee), surcharge on personal income tax and introduced through a money Bill by the minister of finance and earmarked for use by the fund, subject to section 57”.

Besides comprehensive medical schemes falling away, most healthcare – including doctors’ visits, medicines, operations and hospital stays – would be free for everyone and medical schemes would not be able to provide cover for services that were paid for by the NHI.

Democratic Alliance (DA) shadow minister of health Michele Clarke said the party was concerned that the ANC had chosen to ignore all concerns and objections from opposition party members, the parliamentary legal services, the public and health and other stakeholders and “bulldoze the NHI Bill through parliament”.

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“As the DA, we have provided extensive input into the Bill and have asked a multitude of questions. None of these were ever answered to our satisfaction. In fact, all objections and requests for further information or studies were brushed aside,” she said.

NHI Bill for elections

“It’s blatantly obvious the ANC is using the NHI Bill as an electioneering tool to win over voters.

“The finance minister has made it clear that there is no money to implement the NHI. It will bankrupt SA and cripple the already struggling health sector. The DA will consider legal action, along with civil society, should the president undersign it.”

Medical aid scheme Unity Health welcomed the idea of an NHI. It noted, however, it “will take at least another 10 to 20 years to be fully operational if done efficiently and if funds are available”.

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“The additional required funds for the NHI to be fully operational after allowing for the removal of the medical scheme tax credit is about R250 billion, which is about 17%-20% of our total estimated tax revenues in 2019-2020,” it said.

“We know increasing VAT by a single percentage point has had a significant impact on consumers and the economy, so it is irrational that an additional R250 billion be raised through higher taxes.”

Insufficient resources

Discovery Health did not want to comment on the new version of the Bill but in 2019, said its “strong view is that limiting the role of medical schemes would be counterproductive to the NHI because there are simply insufficient resources to meet the needs of all South Africans”.

Limiting people “from purchasing the medical scheme coverage they seek will seriously curtail the healthcare they expect and demand”, it said.

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“Crucially, by preventing those who can afford it from using their medical scheme cover, and forcing them into the NHI system, this approach will also have the effect of increasing the burden on the NHI and will drain the very resources that must be used for people in most need.”

In the latest version of the Bill (B 11-2019) on the Parliamentary Monitoring Group website, little appears to have changed in this regard.

According to the department of health, if the NHI was going to successfully deliver healthcare services to all patients, it would have to procure services from both the public and private sectors.

– lungas@citizen.co.za