‘Money for NHI Bill needs to come from business, too’

The National Health Insurance (NHI) Bill aims to creating a single public health fund, financed through taxes and contributions from higher-income individuals – but government’s inefficiencies in state-owned entities and the health sector raises red flags.

Widespread mismanagement, incompetence and rampant corruption has impacted the public’s right to universal access to healthcare – and to implemented the NHI successfully, government needed the support of the private sector, the Board of Health Funders said.

Managing director Dr Katlego Mothudi said it would be easy to get the private sector on board because there was willingness to collaborate.

“Government does not have unlimited resources looking at financial infrastructure, technology or otherwise. So, for a project this big, it’s not possible for government to run the project by itself.

“The Bill calls for partnership or collaboration but, largely, at a service provision level in that there will be contracting of private sector entities, facilities, healthcare,” Mothudi said.

With regards to funding, if the private sector was excluded, it meant there would be a drop in the available fund to about 4% of the GDP.

He said this would further mean a reduced coverage or access to healthcare services.

“And what has been noted around where the money could come from in terms of taxation, it would take a lot more to raise money from taxes than if you were to just collaborate with medical schemes and find the model,” he said.

“The solution would be in a virtual pooling of resources, very much like what we did during Covid.

“So it is possible to virtually pool resources, whether looking at human capital or the financial resources which are still under guidance by the government through the Bill or another mechanism. That’s the collaboration the private sector actually seeks,” Mothudi said.

However, chief economist at Efficient Group Dawie Roodt said the NHI would not work for two reasons: “There was no money and this government was useless and would not be able to implement it.

“They have to tell us where the money is going to come from. I cannot see where they will get the funds,” he said.

Roodt said there were a couple of pilot projects which were complete disasters.

“I’m sure the moment the president signs that law, somebody will stop everything by going to court.

“This will go on forever with court cases and, obviously, the ANC government does not want anybody else to play with them, especially if they play in a pot full of money,” Roodt said.

“I cannot see how they are going to get the private sector involved in the way that they’re envisaging.”

Professor Sethulego Matebesi, political analyst from the University of the Free State, said it had been seen on numerous occasions how new policies seemed to be silver bullets that would solve all the problems – and it was the same with the NHI.

The NHI needed buy-ins from private companies but private companies would be cautious because of the well-known corruption.

He said government not only needed buy-ins but would have to demonstrate they had the interests of the intended beneficiaries at heart.

“We are very good at initiating policies but implementation becomes a huge problem.”