Those who are concerned about the proposed National Health Insurance (NHI) bill do not oppose the concept of universal health care and wholeheartedly agree that access to health care should be a constitutional right – rather than a privilege.
“We are indeed opposed to a bill that is inherently so flawed that it will jeopardize citizens’ constitutional right to health care,” says the medical fund Bonitas after the controversial bill was recently approved in parliament.
Lee Callakoppen, chief officer of Bonitas, says the bill in its current format is a funding mechanism, not a concept of universal health care.
“Pragmatically speaking, the road to universal health care through the phased implementation of NHI must begin with coverage for the vulnerable groups, before expanding to cover more affluent sections of the population.”
This implies that there will be an inevitable period of coexistence between medical schemes (as they currently look) and the NGV fund. In this scenario, the NHI fund should start by providing comprehensive primary health care services before adding higher cost services, such as hospitalization.
Callakoppen says it is still unclear at this stage which services the NGV will offer, would Pres. Cyril Ramaphosa passed the bill. It is also unclear what role – if any – private medical funds will play.
“What is worrying is that the bill proposes the deletion of medical funds in its current form and only refers to complimentary services. However, we believe the only way for the healthcare system to develop is through interdependent relationships, with public and private healthcare co-existing.”
Momentum agrees with this.
The financial services group also believes that more health services should be offered to more people for less. However, Momentum also does not believe that a single funding model and a limitation on the services that medical schemes offer is the answer.
Momentum believes the introduction of low-cost benefit options can serve as a first step to improve access to healthcare for millions of South Africans.
“The optimal starting point for reforming health systems is to use what is in place and then take progressive steps towards universal health care.
“To achieve the goal of universal access to health care we need extensive cooperation between the private sector and the government… The restriction on medical schemes to only provide cover for services not covered by the NHI will be very damaging to the health care system be.”
This is how the road ahead looks like
RNews previously reported that the bill was approved in parliament last month, but several legislative processes are still needed to finally put it into effect.
The National Council of Provinces (NRP) select committee will now refer the bill to the nine provincial legislatures, each of which must launch their own public consultation process.
The provincial representatives will then report to the committee, before the committee will draw up a final version of the bill and send a report of proposed changes to the NRP.
The NRP will then consider the report and vote on the bill. Each province has one vote.
If the council accepts the bill without amendment, it is presented to the president for approval. If the NRP makes changes, it is referred back to the national assembly for approval.
If the national assembly and the NRP cannot come to an agreement, a mediation process is followed.