Implementing NHI with the Bill in the current form will undermine it, says Adrian Gore

Discovery CEO Adrian Gore. File photo: Simphiwe Mbokazi/ Independent Newspapers

Discovery CEO Adrian Gore. File photo: Simphiwe Mbokazi/ Independent Newspapers

Published Dec 12, 2023


Implementing the National Health Insurance (NHI) with the NHI Bill in its current form would undermine it, Discovery CEO Adrian Gore said yesterday.

He said yesterday the country did not have sufficient money to buy comprehensive benefits for South Africans.

"The fundamental problem here is the lack of funding. That is the core of the problem,“ he said.

Gore said the NHI Bill in its current form would seriously destabilise taxpayers to funding the NHI.

“That is problematic so it seems in a sense irrational when you look at the funding levels of what is available,” Gore said.

South Africa faced the “tragedy” of a narrow tax base and high levels of unemployment.

Discovery reiterated that from the word go they had declared their support of the NHI.

“We have tried to help out in various pilot projects or processes over many many years. But one of the many difficulties has been that given on this issue especially section 33 is that there has been no movement on it. That is very very disappointing from our perspective. We are hoping in the final stages the President will apply their mind to this issues.”

Discovery had tried to model what would have to be done to at least offer the medical schemes’ Prescribed Minimum Benefits (PMBs) as medical schemes had a set of benefits that are PMBs they must offer without co-pay limits.

“These are a set of minimum benefits that may be an anchor for what NHI should aspire to do. PMB amounts are currently R1130 per month per person to provide,” Gore said.

Currently public sector spend, on more than 50 million or so people not covered by medical schemes, is roughly R407 per month per person.

This as medical schemes were spending R2300 a month on medical scheme benefits.

Gore said assuming that medical scheme credits were available and the government subsidy was available, the country would still have to raise over half a trillion rands.

He said to do that South Africa would have to increase taxes by 80% to do that.

Gore explained further.

He said people in medical schemes made contributions out of private money.

“If they (people) are forced to stop paying those contributions the only way to get hold of that money is to raise taxes. So the assumption here in this analysis is to raise R200 billion in taxes as the National Department of Health has said. When you add it all together you have a total potential funding per annum of R531 billion. That is not just in the target numbers mentioned in various areas.”

However, the government had no fiscal space to raise this amount of funding.

“We assume you get R100 billion out of the tax-take in today's environment, which is undo able. The subsidies and contributions to medical schemes you get R513 billion,” he said.

“This raised two questions, firstly, the actual amount of money to cover all South Africans heathcare? Secondly, what will happen to medical schemes?” he said.

Gore said even if your raised taxes, your health benefits would be cut and it was not possible to provide for all South Africans.