Johannesburg; 8 November 2023 – As the National Health Insurance (NHI) Bill progresses through the approval process in the National Council of Provinces (NCOP), a diverse coalition of stakeholders have joined forces, urging the South African government to diligently evaluate the concerns raised regarding the proposed bill.
During the recent Kwa-Zulu Natal leg of the Frank Dialogue on NHI, hosted by esteemed media anchor and Leadership magazine editor, Prof JJ Tabane and his team in Umhlanga, Dr Katlego Mothudi, the Managing Director of the Board of Healthcare Funders (BHF), underlined the imperfections existing in both the public and private healthcare sectors. Dr. Mothudi cautioned against dismantling the private sector to expedite the attainment of Universal Health Coverage, a key global agenda, emphasizing that medical schemes are a national asset that plays an indispensable role in the healthcare ecosystem.
Dr. Mothudi further underscored the essential pillars for strengthening the health system, encompassing leadership and governance, service delivery, health system financing, health workforce, medical products, vaccines, technologies, and health information systems. While the NHI bill covers the financing aspect of this framework, it is crucial to acknowledge that it is not the sole solution to the healthcare challenges faced by South Africa.
Prominent figures in the healthcare sector, including the Minister of Health, Dr. Joe Phaahla, Dr. Kgosi Letlape, Zwelinzima Vavi, Dr. Nicholas Crisp, and Nozibele Tshobeni, participated in this dialogue. The primary objective of these discussions has been to foster a constructive and inclusive discourse among various professionals in the sector, working closely with the Minister of Health to address concerns related to the proposed NHI Bill.
Prof. Tabane emphasized the importance of resolving multiple issues before the successful rollout of the Bill, acknowledging that the health crisis in South Africa is a matter of significant concern, necessitating the implementation of universal health coverage (UHC).
Asked about the future role of medical schemes under NHI, Dr. Crisp reiterated that the NHI was not intended to abolish medical aids but to ensure that all South Africans have access to affordable healthcare. He clarified that the bill seeks to establish a different financing method—a single fund to provide the majority of the health benefits required for the nation.
However, Dr. Mothudi disagreed with this approach, highlighting the benefits of a multi-payer system, originally proposed in the first NHI Green Paper. He pointed out that a multi-payer system could be a more effective model, particularly in a South African context characterized by issues of fraud and corruption.
In her concluding remarks, Nozibele Tshobeni from Sizwe Hosmed expressed support for the concept of NHI but questioned the implementation approach, suggesting that pushing the Bill through might be hasty.
Dr. Mothudi concluded by noting, “We are not that far apart in our discussions on this, but where we are drifting apart can be answered by the question ‘why are we here?’ The Medical Schemes Act, for example, was promulgated in 1998 – post-apartheid. So we must take responsibility for these challenges. Secondly, Government must provide stewardship, being responsible for the lives and healthcare of every citizen. Right now we only have one Department of Health, not one for the public and one for the private sector.”
It was also noted that the private sector “does not run itself.” The National Health Act is there to guide practitioners and establishments on how they should behave, while the Medical Schemes Act is enforced by the Council for Medical Schemes under the stewardship of the Department of Health.
This Frank Dialogue on the NHI Bill serves as a crucial platform for South Africa’s healthcare leaders and experts to voice their concerns, share insights, and work toward a comprehensive and equitable healthcare system that benefits all citizens. It highlights the importance of continued collaboration and thoughtful consideration in the ongoing pursuit of universal health coverage in the nation.
The Board of Healthcare Funders (BHF) is the largest industry association for health funders across 8 countries in the region, with the key aim of enabling its members to provide access to affordable healthcare to health citizens. |
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