Government is capable of implementing NHI

I read articles titled: “NHI: What about critical meds” and the editorial titled: “Can NHI provide meds for 9m?” published in The Citizen on 29 August.

Both posed not only discriminating, but self-interested questions on whether the National Health Insurance (NHI) can provide essential medication for nine million South Africans who merely constitute 14.2% of the population.

NHI could help SA’s majority

The motive behind these questions is dubious.

One needs to ask who provides critical medicines to the 54 million people who solely depend on the underfunded public health system.

It is incorrect or disingenuous to suggest that, under the NHI, there is no guarantee current patients on prescribed minimum benefits will continue to get the same benefits, life-saving treatment in particular.

According to the Medical Schemes Act 131 of 1998 and its regulations, all medical schemes have to cover the costs related to the diagnosis, treatment and care of any life-threatening emergency medical condition, a defined set of 270 diagnoses and prescribed chronic conditions.

At first, I was reluctant to respond to this viewpoint, which appears to be part of the ongoing onslaught by some sections of society, mainly championed by privileged minority groups with the loudest voices, to discredit the government`s health reform to address existing legacies created by apartheid.

It is time to stop driving a wedge between the public and private parallel service provision systems.

Both public and private sectors have problems that need to be fixed.

We know that private health providers do not report on quality and cannot account for health outcomes.

However, it is assumed that patients are getting appropriate care.

The Health Market Inquiry findings, in fact, suggest that private patients often get bad health care with plenty of unnecessary procedures and medicines.

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NHI can expand support that is already there

It is important to point that out that in the past year, besides the millions of patients who received acute and chronic medicines at over 3 500 public health facilities, more than nine million chronic patient medicine parcels were packed and distributed through the Central Chronic Medicines Dispensing and Distribution programme.

This is a free, safe and convenient programme which has played an important role in supporting patients with chronic diseases who were unable to collect their medication from facilities in-person.

The public health departments successfully runs the largest antiretroviral programme in the world.

It is not clear if the concern is due to doubting whether the government can afford to and is capable of keeping chronic patients on treatment, or if there is a defensive and protectionist tone to these concerns.

The so-called incapable government subsidises funding in the private sector to the tune of almost R100 billion every year.

This is by way of R70 billion in employer medical aid contributions for those working for the state, plus over R30 billion through tax rebates or credits for all on medical schemes.

We need to avoid confusing the public. NHI aims to create a single payer and a purchaser-provider split.

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Addressing the funding of the NHI

Regarding funding, this R100 billion spent in the private sector is paid for by the state, but is unfairly spent on the more privileged and needs to be redistributed to benefit all citizens.

On the delivery front, millions of people are provided with necessary medicines every day in the public sector.

The more important issue now is how to harness all resources to benefit everyone.

The capacity of government to ensure everyone irrespective of socioeconomic status receives health care based on their needs was tested during Covid vaccination period.

We were able to work together to ensure that over 20 million people got life-saving vaccines. Let’s not ignore the truth about the existing inequalities.

We should allow the principle of humanity to guide us as a country as we move forward into the future.

There is no child of a lesser God in South Africa and no-one chose to be poor or unemployed. Diseases do not discriminate.

• Mohale is spokesperson of the national health department

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