During a recent address, MEC for Health and Wellness, Nomantu Nkomo-Ralehoko stated that her department is readying itself to implement the National Health Insurance (NHI) bill.
The NHI is a compulsory state-controlled medical fund that is set to revolutionise the country’s healthcare system.
The MEC welcomed three new CEOs of academic hospitals within the province, stating that the appointments will help the NHI roll-out in due course.
“I would like to extend my warmest congratulations to Dr Nthabiseng Makgana, Dr Lehlohonolo Majake and Dr Fhatuwani Mbara for their appointments to serve in our academic hospitals. These positions carry a great responsibility in ensuring the delivery of excellent healthcare services to the people of Gauteng,” said Nkomo-Ralehoko.
“As we ready ourselves for the implementation of the NHI, it is imperative that we have capable leaders at the helm of our academic hospitals. Their expertise and strategic vision will play a vital role in advancing our healthcare system, promoting equity, and improving access to quality healthcare services for all.”
Majake of Steve Biko says she and her staff are ready to engage with the public on NHI.
“My expectation is to ensure the hospital fulfills the mandate of the MEC by providing the best care to South Africa and to be the hospital of choice to patients and staff. I will also engage with the community about NHI,” she concluded.
During a gathering of the National Press Club late last month, the head of the NHI and deputy director-general of the Department of Health, Dr Nicholas Crisp, explained that the fund would cover healthcare for all living in South Africa.
The bill has not been short of critics that believe it would cripple the healthcare system and tighten the already strained pockets of South Africans.
Crisp expressed his delight that the government had won its most recent NHI court case against trade union Solidarity on 28 February.
“They wanted to stop us from continuing to hire 44 people to make strategies around the NHS. The court said they cannot take away the right from us to plan for the implementation. Now we can continue. The ruling brings us one step closer,” explains Crisp.
He believes the enactment of the bill will improve access to health care for those who previously faced barriers due to limitations such as geographic location.
He assures residents that the private medical services sector will not be nationalised and as such private practices, pharmacies and hospitals will still be available. South Africans will still be able to register with their own preferred healthcare provider
“With implementation, someone in a job like a security guard or gardener in my fairly affluent neighbourhood, for example, would have access to the same hospital I can go to and wouldn’t have to travel to a government facility far from his job,” said Crisp.
Solidarity however says that it will continue to fight the bill even if the president signs it, to protect the sovereignty of the health of South Africans.
“Our ultimate aim is to stop all facets of the NHI, in order to grant the people of South Africa sovereignty over their own health. We have therefore prepared our case and will submit it to the court immediately once the NHI bill is signed by the president,” said Theuns du Buisson, economic researcher at the Solidarity Research Institute.
Du Buisson says Solidarity’s research indicated that South Africans will not be able to afford the bill and implore the president to pay the costs himself, should it be implemented.
Solidarity predicts huge tax implications that will hit the working class who are already struggling.
“Massive tax increases would be required. The form of tax, which seems to be preferred by policymakers to fund the NHI is a payroll tax, which would be roughly 13%. If this tax is implemented, it would mean that even minimum wage workers, who have never paid income tax, would be forced to pay this tax. All other income earners would pay this 13% tax on top of their current tax bill. As it is a payroll tax, general income tax rebates would not apply to it and all workers, even those earning the minimum, would have to pay it,” said Du Buisson.
He said that even if the president signed the bill, an effort of this magnitude would take years to implement and Solidarity would do their best to prevent it, saying that “sanity will prevail”.
“The NHI would reduce healthcare provision for everyone, including the poor. We therefore acknowledge the inequality, but we do not view the NHI as a means of resolving it. In contrast, the NHI would reduce healthcare to the poor.”
The Department of Health has not yet given a timeline but has indicated that the new bill may not be fully implemented until 2026 and it is estimated that it will cost the country R265-billion annually.
The fund will pay for medical services provided to South African citizens, permanent residents, refugees, prisoners, certain categories of foreign nationals, all children regardless of nationality, as well as asylum seekers and illegal aliens for reportable conditions and emergency medical services
The NHI fund will pay the clinic, general practitioner or hospital as long as they have a contract with the NHI fund. The member of the public using the service will pay nothing.
For registration, the department plans to use one digital registration system. Everyone who was registered during the Covid-19 vaccination programme has already registered for the NHI
For new registrations, an ID book, passport or other identity document would be required and fingerprints will be taken and placed on the NHI system.
When visiting medical providers such as doctors, clinics and hospitals, a member of the public must have proof of identity. Officially designated registration facilities may also be announced.
The registration facilities or centres will be announced when the registration process begins.
The facilities will issue NHI cards. This will reduce the role of medical aid funds as the services they cover will only be for treatment administered by specialists.
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