Cape Town - Long lines and hours spent waiting to access emergency specialist healthcare at public hospitals could be a thing of the past if the government’s National Health Insurance (NHI) Bill becomes law.
At the core of the NHI is a National Health Insurance Fund that will pay private hospitals and healthcare practitioners a prescribed fee for services rendered to those that otherwise cannot afford it.
Expert opinion on the NHI Bill before Parliament is divided between those who are wholeheartedly in support and others who are adopting a wait-and-see attitude.
Implementing the NHI may fulfil the government’s constitutional obligation to provide quality universal healthcare for all, but the system has caused debate, with people arguing both for and against it ever since the idea was mooted.
Introducing the bill in Parliament, National Health Minister Zweli Mkhize said: “For too long has our healthcare system operated in an unsustainable and unjust manner: the public healthcare system shoulders the lion’s share of disease burden in this country, looking after 84% of our population with less resources than the private health system that services only 16% of the population.”
On Wednesday, Damian McHugh, head of health marketing at Momentum Group, said that while the medical aid supported universal healthcare (UHC) and there was no debate that inequalities existed in the health system as it was at present, “how we go about achieving UHC is the question”.
McHugh said Momentum was busy studying the bill before saying anything about it, but was ready to support any system that “delivers more healthcare for more South Africans at a lower cost”.
Meanwhile, the Mediclinic Group, which operates a range of multidisciplinary acute care private hospitals across the country and comes under a grouping known as #FriendsOfNHI, put out a statement that said the bill was “a major step forward in the introduction of UHC”.
“The private sector has a valuable contribution to make in this regard.”
President of the Health Professions Council of SA (HPCSA) Kgosi Letlape meanwhile said in a statement: “We hope that as we engage with the NHI Bill, we will persuade the authors (of the bill) to talk about NHI contracting with providers, rather than accrediting them.”
Letlape said: “We don’t want the NHI to become the new medical aids that are choosing who can live and who can die.”
At the same time, Anele Yawa, general secretary of the Treatment Action Campaign (TAC), said the organisation would wait until the bill was enacted, before commenting on it.
However, he said: “In South Africa we have a population of about 57 million of whom 42 million are dependent on the state for healthcare, but the workforce in the health system is only about 400 000 people. How can they cater for 42 million people?”
On the subject of affordability, Ronelle Burger, an economist and researcher in the Faculty of Economic and Management Sciences at Stellenbosch University said: “According to the household surveys, the main constraint to having insurance is affordability. There are many people who would like to have insurance, but simply cannot afford it.”
Burger pointed out that there were no user fees for using primary health clinics and fees at hospitals were means-tested and seldom enforced and that this was echoed in the surveys, which showed that affordability was not a constraint to access to public care. “The demand for private care, amid free public care is interesting and important, and part of what we as researchers are trying to understand in more depth.”
The SACP, which is part of the #FriendsOfNHI, said: “We will continue pushing for the successful introduction of NHI in the interest of quality healthcare for all.”