The National Health Insurance (NHI) Bill which was signed by President Cyril Ramaphosa last week is set to provide all South Africans with affordable healthcare when it is implemented.
This could mean that it will bridge the gap between those who do have access to private healthcare and medical aid with those who don’t have access to it.
In his weekly newsletter, From the Desk of the President, Ramaphosa said that the NHI Act will bring South Africa one step closer towards universal health coverage.
According to the president, there has been parallel healthcare systems operating in our country, one for the poor and another for the rich.
Ramaphosa made a case for the NHI in the newsletter, saying that around 84% of people in the country use public health facilities, while 16% are covered by private medical schemes - which he argued were heavily subsidized by the government - allowing them access to private health care facilities which were only accessible to a small percentage of people despite the government heavily subsidizing them.
He said very few people used both the public and private health facilities.
“We therefore have a situation where the state both directly and indirectly helps to fund a private health care sector that serves only a minority of society...
“This has perpetuated inequality, with the quality of health care one receives being determined by one’s ability to pay. This runs contrary to our aspiration to be a society that is just and equal,” said Ramaphosa.
Fazlin Swanepoel, head of Alexforbes Healthcare called the NHI a centralised fund responsible for the purchasing of healthcare services on behalf of all residents and qualifying residents of South Africa.
This means that all South Africans including those who are feeling left out because they don’t have medical aid will have access to good healthcare.
Swanepoel said that although the NHI lacks clarity of how the NHI will be funded, as well as what prescribed services will be covered, it is step towards achieving universal healthcare.
“Universal healthcare aims to provide equal access to healthcare services for all citizens and by this very definition will benefit all residents and qualifying residents of South Africa,” Swanepoel said.
Craig Comrie, chairperson of the Health Funders Association (HFA) agrees that NHI will give people like those who don’t have access to medical aid more opportunities to access good health care.
"Despite the predominantly negative attention directed towards NHI, it's imperative to acknowledge its potential for significantly improving accessibility to quality healthcare,“ Comrie said.
“While criticisms abound, it's crucial to recognise the positive impact it could have in extending affordable, high-quality private healthcare to millions more South Africans if appropriately implemented.”
However, NHI will need to be implemented before it can actually benefit people that are not members of medical aid schemes.
For the fund to be established and various governance structures within the proposed fund will need to be set up and filled. The establishment of the fund also requires a set of benefits to be proposed and providers to be contracted with the fund to provide benefits.
“Based on the phased approach to implementation this may only be possible after 2028 so there will be no benefit from the fund in the meantime,” Swanepoel said.
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