SA needs more time, better economy for NHI – experts

There is already evidence the NHI is set to fail and that it would ultimately drive healthcare professionals away, the SA Private Practitioners Forum says.


A better economy can make universal healthcare a reality, but South Africa needs more time to make the National Heath Insurance (NHI) Bill work, according to a market expert.

Private healthcare lobbyists and other interest groups are intensifying their warnings on the economic dangers of sidelining private healthcare and effectively shrinking its market – a common interpretation of what the NHI would effectively do.

Head of capital markets research at Intellidex, Peter Montalto, said even if South Africa sorely needed NHI, it simply couldn’t afford to make it work.

Estimates from the Davis Tax Committee’s last report on the NHI suggested that the system would cost an additional R165 billion to the fiscus, according to Montalto. But for all intents and purposes and given a better economic outlook for South Africa, there was reason to believe that it could work.

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Partially modelled on the British national health system, the NHI had some key political differences in its inception, Montalto said.

“The British system obviously had a much earlier start and one of the differences is that [South Africa] already has a well developed private healthcare system which is an established market and is meeting needs.

“Private healthcare had not been built up in the UK, so there is a different dynamic.

“In SA, it means replacing something that is already there with something of better quality, so that will be more of a political problem. In England, most people don’t have private healthcare so that makes the comparison a bit harder.”

The South African Private Practitioners Forum (SAPPF) suggested there was already evidence the NHI was set to fail and that it would ultimately drive healthcare professionals away.

SAPPF said it remained concerned with the ability of government to successfully implement the Presidential Health Compact to radically improve the quality of the public sector.

“Failure of the health compact to turn around every facility in the public healthcare sector will mean that the public sector facilities will not be of sufficient quality to contract with the NHI fund. The continued implementation of NHI, without confirming that the Presidential Health Compact was successful, could do immense damage to the healthcare system and could result in a shortage of public sector service providers for the NHI fund to contract with.”

The group was also concerned with the lack of clarity around the compensation of private practitioners, leaving it up to the executive to make regulations on such reimbursement models.

Yesterday, Freedom Front Plus blamed healthcare giant Discovery Group’s historic dip in share price on the recent tabling of the NHI Bill.

The party suggested the effect on the economy was already being felt, with Discovery Group’s shares falling 8.5% on the JSE last week.

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