The NHI unpacked by the MEC for Health
Health MEC Phophi Ramathuba says the main aim of the National Health Insurance (NHI) is to ensure that everyone has equal access to quality healthcare.
POLOKWANE –Â The department held a roadshow at the Seshego Hospital on 11 October, outlining some elements of the NHI.
She said the department is working closely with the House of Traditional Leaders for them to be included as medical practitioners. “Our biggest challenge with the traditional leaders is the establishment of a board that will regulate the registered practitioners and their powers.”
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She says they are doing this to ensure the safety of all patients. Ramathuba says this roadshow is a bid to get the communities involved and to give their input on the NHI. She encouraged members of the public to go on to the department’s website to give their input on the bill. Speaker of the Provincial Legislature, Mavhungu Lerule-Ramakhanya said the role of Legislature is to be the voice of the people. “This is a government for the people by the people and this occasion here today was to allow the people to govern.”
NHI BILL
National Health Insurance (NHI) is a healthcare financing system designed to collect funds to purchase and provide access to quality healthcare services for all South Africans based on their health needs. This is done irrespective of citizens’ socioeconomic status. NHI is a government entity derived from Section 27 of the Bill of Rights of the Constitution of the Republic of South Africa in which a commitment is made for the state to take reasonable legislative and other measures, within its available resources, to achieve the progressive realisation of the right to health care
FUNDING
The NHI Fund will receive money from general tax and from special contributions by individuals who earn above a specified level, and their employers. The NHI Fund will get a large amount from general taxes. Every person in South Africa will make a contribution to the fund because we all pay some kind of tax. Those of us who earn more will contribute more where people with lower incomes will not make any direct payment to the NHI Fund.
Every person earning above a specified amount will, however, be required by law to make a monthly NHI payment that in almost all cases this will be lower than medical scheme tariffs. Employers will assist the NHI Fund by ensuring that their workers’ NHI contributions are collected and submitted, in the same way UIF contributions are made. Employers will match their employees’ contributions to NHI.
INSTITUTIONS
The NHI Fund will provide finance for healthcare. It will not manage hospitals, clinics or the practices of GPs, dentists, specialists and other health professionals. The NHI Fund will enter into contracts with public and private hospitals, specialists, public clinics and private GP practices to deliver health services free of charge to every South African citizen and legal resident. Every hospital, clinic or health practice that wants to be part of NHI will have to be certified beforehand by the Office of Health Standards Compliance. Many hospitals and clinics will need major upgrading so that they can achieve the standards required by the Office of Health Standards Compliance and become certified. Government plans to spend large amounts in the next few years to get these facilities into shape and to ensure that they are equipped and staffed in a way that will guarantee healthcare is available to all.
PATIENTS
All residents of the country will be covered. Foreign nationals will be covered for emergency services only. All NHI patients will enter the healthcare system at the primary care level at a clinic or a general practitioner. The primary care health professional will refer patients for specialist or hospital treatment if this is necessary. NHI will not pay for patients to see specialists unless they have been properly referred from a primary healthcare facility.
SERVICES
If you have a genuine need for healthcare, including hospitalisation. Funds do not run out. Health professionals will treat you according to national guidelines that follow good medical practice and are approved by the NHI. NHI will not pay for procedures that are not required for health reasons.
MEDICAL PRACTITIONERS
Under NHI, you will be in a position to choose a primary health care facility, a clinic or GP practice and register with that facility to receive services there. Special arrangements will be made for those who live in areas where health facilities are in limited supply, while the upgrading of rural facilities is in progress.
