Medical and health funder bodies slam National Health Insurance Bill

The National Health Insurance Bill continues to receive criticism (Photo by Axel Heimken / POOL / AFP)

The National Health Insurance Bill continues to receive criticism (Photo by Axel Heimken / POOL / AFP)

Published Jun 14, 2023


Durban — The SA Medical Association (Sama) says South Africa cannot be heading towards National Health Insurance (NHI) when it is not able to attain its health-care workers.

Sama chairperson Dr Mvuyisi Mzukwa said the country was producing enough doctors but the system was not absorbing the doctors.

The government said the objective of the NHI Bill is to provide universal access to quality health care for all South Africans as enshrined in the Constitution. It said NHI is a health financing system designed to pool funds to provide access to quality, affordable personal health services for all South Africans based on their health needs, irrespective of their socio-economic status.

This means every South African will have a right to access comprehensive health-care services free of charge at the point of use at accredited health facilities such as clinics, hospitals and private health practitioners. This will be done using an NHI card. The services will be delivered closest to where people live or work.

Speaking to Newzroom Afrika, Mzukwa said there were nine medical schools, doctors who are trained in Cuba and those who study outside the country and come back to write the exams at the Health Professions Council of SA (HPCSA) and qualify.

“We have a lot of those but they are not employed. If the Treasury says it does not have money, hospitals won’t have any funded posts to absorb such doctors,” he said.

He said there was already a shortage of nurses but there was no funding from the government to grant the health-care system capacity.

Mzukwa added that the shortage of health-care workers led to patients being victims of bogus doctors.

DA spokesperson on Health Michéle Clarke said the NHI Bill, which was approved in Parliament, would destroy health care in the country.

She said at the moment about 9 million people have medical aid. Once the NHI is implemented, these 9 million will have to be accommodated in an already overburdened public health system.

“Instead of going directly to their privately paid doctors or hospitals, they will now be competing for treatment in the public health system with its severe staff and resource constraints.

“The last indicators of the national surgery backlog were more than 168 000,” she said.

Clarke added that the ANC might argue that through the NHI Fund, private health facilities would be servicing a larger portion of the public previously unable to access their services.

However, this is based on the ludicrous assumption that those 9 million South Africans would continue to pay for their medical aid when it no longer benefits them.

“Without private patients funding them, private health facilities would be dependent on the government for their funds, effectively making them public health facilities without the benefit of a dedicated budget.

“As the government has done no feasibility studies, we don’t know how many facilities would survive government-imposed fee structures. These potential closures would further decimate the health sector,” said Clarke.

The Health Funders Association (HFA), representing about 73% of open medical schemes and 50% of total medical scheme membership in South Africa, rejected the NHI Bill in its current form.

It said it perpetuates several tenets which the association believes would undermine the quality of health care and the objective of moving towards universal health coverage in South Africa.

Chairperson of the HFA Simmi Bassudev, said: “The HFA believes that adding the nearly 9 million lives covered by medical schemes on to an already overburdened and failing public health system would be detrimental to the quality of care.”

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