The Health Minister Aaron Motsoaledi has revealed the new National Health Insurance Bill and Medical Schemes Amendment Bill Picture: Jacques Naude
DURBAN - South African citizens that can pay towards the newly introduced NHI fund will have to do so regardless of whether they have medical aid or not.

On Thursday the National Health Insurance Bill (NHI) and the Medical Schemes Amendment Bill was introduced by Aaron Motsoaledi, the Health Minister.

According to the Department of Health, the NHI is a financing system that will make sure that all South African citizens (and legal long-term residents) are provided with essential healthcare, regardless of their employment status and ability to make a direct monetary contribution to the NHI Fund.

The bills will allow for more access to medical healthcare through National Health Insurance, and could mean that both government and private healthcare systems will undergo a huge shift.

Neil Kirby the head of healthcare and life sciences law at Werksmans Attorneys said that the impact of the bills will likely be dramatic and they face challenges from all the people that are involved.

Will South Africans have to pay for NHI?

Thee NHI Bill does not outline who will be paying for the NHI to be financed or how the payments will be done, however, it seems like taxpayers will be the financiers.

According to The South African, the NHI fund is compulsory for South Africans that can afford to pay. Also, South Africans that do already have medical aid will also have to pay towards the fund.

The fund will purchase healthcare services, medicines, health goods and health-related products for the public from service providers that certified, accredited and contracted.

The National Treasury has been tasked with coming up with a way to finance it. The bill says that Treasury will have to set aside funding from the national budget annually for the NHI. It has been estimated that the scheme will cost R182 million each year.

One funding avenue that has been suggested is taking away medical aid tax credits while it has been speculated that the funding will come from the introduction of new taxes.

However, according to the Health Minister, it will be the rich subsidising the poor, the young subsidising the elderly and the healthy subsidising the rich.

What services will be covered?

The NHI's purpose is to be the main buyer and financier of certain healthcare services that will be available to all the citizens if this country. Although that services that will be covered by the insurance are unknown right now.

According to NHI documents, the plan is described as being comprehensive but does not fully explain everything. However, the types of services that are being funded by the NHI could decide how much it will cost the taxpayer.

Date of NHI implementation

The NHI Bill does not give an actual date of implementation so when the system will come into effect is unknown. The South African public has been given 30 days to give feedback on the bill but according to the Health Minister, he expects that the bill will have to face many court challenges.

The Democratic Alliance estimates the health insurance scheme will take between 12-15 years to be implemented.

Will your current medical aid be affected?

The medical aid sector will definitely be affected by the introduction of the NHI bill and the Medical Schemes Amendment bill. However, the extent of the impact on the medical sector is unknown.

Kirby said that it is likely that medical aids will become an auxiliary system to the NHI. Schemes may choose to reduce the services that they cover, different groups may merge while some systems will completely shut down.

How will healthcare providers be impacted?

Healthcare providers will have to be registered, certified and accredited through the NHI. Presently no details have been released about how the process takes place.

According to Kirby, the qualification process, within and of itself, means that particular providers may be prevented from providing NHI benefits and, in turn, from receiving payment for the supplying of specific health care services.

Will NHI work?

The feasibility of the NHI has been called into question and the bill itself has faced tough criticism from the time that it was created.

The common perception is that South African public healthcare system is not at the stage that would make universal healthcare possible.

Kirby said that in the wake of the Life Esidimeni findings and statements concerning the ability of the public healthcare sector to actually provide access to healthcare services at all in settings, the introduction of the NHI is a controversial move.