National Health Insurance to improve SA health system

The South African government is in the process of introducing an innovative system of healthcare to benefit all South Africans and legal permanent residents, regardless of their economic class.

The National Health Insurance (NHI) is based on two principles; the right to quality healthcare services and income/risk cross-subsidies.

This is according to a presentation by Heidi Kruger, Head of Corporate Communications at Board of Healthcare Funders of Southern Africa (BHFSA).

The system will cover comprehensive benefit package dependent on interventions considered important in improving access – offering financial protection to less advantaged groups and enhancing redistribution of healthcare services.

Kruger identifies the current challenges of the public health sector as:

· HIV/Aids and Tuberculosis (23 times global average, TB highest in the world)

· Maternal, infant and child mortality

· Non-communicable diseases (diabetes, high blood pressure, cancer etc.)

· Injuries/trauma

She highlights some improvements in the nation’s health system over the years:

· Drop in new infections from 540 000 to 370 000 between 2004 and 2012 (Sources: UNAIDS and 2011 census and surveys).

· New infections among children under the age of 15 decreased from 90 000 in 2004 to under 10 000 last year.

· Drop in number of AIDS deaths from 330 000 to 240 000 between 2004 and 2012 – projected to fall to below 150 000 in 2016.

· Government’s roll-out of the antiretroviral (ARV) therapy programme had averted an estimated 780 000 deaths between 2004 and 2012.

· An estimated 2.7 million people receive ARV drugs in South Africa, making it the largest ARV programme in the world.

The country’s two tier health system could be the reason for the mal-distribution of key healthcare resources leading to a skewed ratio of professionals in favour of the private sector and contribute to the bad outcome

of the system.

According to the presentation, the 8.8 percent of Gross Domestic Product (GDP) spent on health is split at an estimated 4.3 percent in the private sector, with 8.5 million beneficiaries and 4.5 percent in the public sector, with 42 million beneficiaries.

The health expenditure in the private sector amounts to approximately R112 billion for only 15 percent of the population while the public sector’s expenditure, with 84.5 percent of the population totals to an approximate of R110 billion.