While supportive of universal healthcare, the BHF questions the recently passed NHI Bill’s lack of clarity on funding and potential to limit the role of medical aid companies.

The Board of Healthcare Funders’s position on the National Health Insurance (NHI) has not changed. It agrees that there is a need to have universal cover for all citizens.

However, it is concerned by the way that the current NHI Bill has been written because it reduces the role of medical aid companies and by extension reduction of access to health services for beneficiaries.

The BHF does not believe that the recently passed NHI Bill (click here) will fulflll the mandate for universal cover because it only tackles the purchasing component, yet healthcare provision is beyond just money.

There are other critical issues, which the Bill is silent on, such as how it will be funded, how infrastructure will be improved, capacity and resources.

The two main areas of concern in the Bill for BHF members are the relegation of schemes to provision of complementary cover and the proposed amendments in the Schedule of the Bill to the Medical Schemes Act.

The NHI Bill envisages that medical schemes will eventually only be allowed to offer “complementary cover”. Complementary cover is defined as “third-party payment for personal health care service benefits not reimbursed by the Fund, including any top up cover offered by medical schemes registered in terms of the medical schemes act or any other voluntary private health insurance fund.”

There is no indication of what is meant by “top up” cover in the Bill. It seems to be a subset of “complementary cover” but not the whole of it. The term “personal health care service benefits” is not defined in the Bill, neither is “personal health care services”.

Section 33 stipulates that the Minister of Health will decide by way of regulations when National Health Insurance has been fully implemented. From that time onwards medical schemes may only offer “complementary cover to services not reimbursable by the Fund.”

BHF believes that the NHI Bill is unconstitutional to the extent that it restricts the rights of private individuals to fully fund their own healthcare through a medical scheme if they so choose.

This will impair their current access they enjoy and the Constitution does not allow the government to deprive people of access to health care that they have currently. This is called regressive or retrogressive action and is constitutionally impermissible. It will also amend the Medical Schemes Act to restrict the cover that medical schemes can provide for health care.

The NHI bill does not address the weaknesses that exist in the healthcare system because even the proposed funding model is unclear and questionable.

Every successful universal cover model in the world achieves this by working with the private sector not by diminishing the role of the private sector. (Watch video here)

BHF is exploring all options available to protect the rights of medical scheme members and medical schemes as a national asset.