THE signing of the National Health Insurance into law by President Cyril Ramaphosa has sparked controversy among ratepayers’ associations and law experts who believe that such a move may cause the already fragile economy to fall apart.
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Weighing in on the newly signed NHI Bill, the chairperson of the Bluff Ratepayers’ and Residents’ Associations, Norman Gilbert, called for cool heads and emphasised the significance of thorough research before implementing such laws that might have a long-lasting socio-economic impact on South African impoverished communities.
The NHI aims to provide universal healthcare access to all South Africans, ensuring that quality healthcare is no longer a privilege but a right for every citizen. However, this initiative is not without its complexities and potential pitfalls.
Norman said, “While the intention is to ensure equal access to quality healthcare, ratepayers may indeed face increased taxes or contributions to fund the NHI. This could potentially lead to higher expenses for ratepayers, especially if the funding model relies heavily on taxation or mandatory contributions.
“Many countries, including First World nations, have struggled to implement and sustain universal healthcare systems due to escalating medical expenses and funding challenges. South Africa’s socio-economic context, including high levels of poverty and inequality, adds to the complexity. Implementing NHI successfully will require careful planning, efficient resource allocation, and a sustainable funding model,” said Norman.
However, he said the universal healthcare system may have both positive and negative impacts on private healthcare practitioners.
“On the one hand, they may benefit from the increased demand for their services as more people gain access to healthcare. On the other hand, they may face new regulations, tariffs and accreditation requirements, which could affect their profitability and autonomy.
“In my opinion, the primary beneficiaries of NHI should be the poor and vulnerable segments of society, who currently lack access to quality healthcare. However, the success of NHI depends on effective implementation, efficient resource allocation and adequate funding. If implemented correctly, NHI could also benefit private businesses by reducing the burden of employee healthcare costs and increasing the overall health and productivity of the workforce. The government’s role is to ensure effective governance, regulation and funding to make NHI a success,” he added.
An attorney at AMS Attorneys Inc, Allison Schoeman, said, “One of the most pressing concerns is the potential emigration of skilled doctors. The fixed pricing model and centralised control under the NHI could drive healthcare professionals to seek opportunities abroad, leading to a shortage of qualified doctors in the country. This brain drain could undermine the NHI’s ability to deliver quality healthcare services, increasing patient loads and waiting times for those who remain.
Schoeman added that Section 27 of the constitution ensures that everyone has the right to access healthcare services.
“The NHI, by becoming the primary purchaser of healthcare services, may limit citizens’ ability to choose their preferred healthcare providers, as private practitioners will be required to contract with the NHI and adhere to its terms. This could restrict patients’ choices, potentially forcing them to use government-approved providers even if they prefer private options.
“The transition to the NHI will likely cause short-term disruptions in service delivery as the system integrates public and private healthcare providers. Patients may experience longer waiting times and varying quality of care during this period,” she added.
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