Plan to meet NHI midway can work

We hope that a proposal for an alternative to the National Health Insurance (NHI) – put forward by the Universal Healthcare Access Coalition (UHAC), representing most health care professional associations in the country – will inject some realism into the fraught debate.

The proposal has been sent to President Cyril Ramaphosa and we hope that he “applies his mind” to it.

In the assessment of UHAC, NHI cannot work in its current configuration which is, effectively, going to amount to the forced nationalisation of private medical services.

Critics have warned that centralising the health sector totally under government control will open up endless possibilities for looting which, in and of itself, will result in a collapse of service delivery, even without a feared mass exodus of professionals from the private medical sector.

UHAC proposes separating funding from service purchasing, as well as improving public health care services.

At the same time, its proposal seeks to expand medical scheme coverage, rather than do away with it.

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This would happen via a government-managed fund to finance medical services for all qualifying individuals, which would reduce the power of private medial aid schemes.

There is really no alternative, in the UHAC’s estimation.

It said: “There is no feasible scenario in which a single tax-financed fund can provide all the coverage for the entire population of South Africa.”

Overall, the UHAC believes South Africa should follow the model of other countries, where the health sector provides care for all based on a combination of funding from tax and through private contributions.

We do not think medical scheme members would be adverse to such a system, especially as it promises to rein in extortionate charges and profiteering in the private sector.

The private groups, too, should welcome this middle-way solution because at least it means they will still have an existence in the future.

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