The Health Minister Aaron Motsoaledi has revealed the new National Health Insurance Bill and Medical Schemes Amendment Bill Picture: Jacques Naude

If you have been paying enough attention to South Africa’s healthcare issues over the past few years, you probably have heard about National Health Insurance (NHI) - the ambitious, universal healthcare insurance fund that will aim to deliver free, top-notch health services to every South African, rich or poor.

This week, NHI was back in the spotlight as Health Minister Aaron Motsoaledi released the long-awaited NHI Bill for public comment, paving the way for the establishment of the NHI fund - a central fund for healthcare services.

Once the bill becomes law, South Africans will be required to pay into the fund before they pay their medical aid premiums, if they opt to continue to be members of medical aids.

This week, Motsoaledi said the NHI would pool the monies contributed by all South Africans, according to how much one earns, and would provide everyone with free access to public and private-sector providers across the country.

Despite NHI being a talking point since 2007, when the ANC adopted the idea at its Polokwane conference, followed by the release of the NHI Green Paper in 2011, which pledged to have universal healthcare in place within 14 years, many South Africans still don’t know much about the fund - almost a decade later.

If you are still struggling to understand what the NHI is all about, here is a simple breakdown of how the fund will affect you in the near future.

What is the National Health Insurance (NHI) Bill?

According to Motsoaledi, NHI is a health financing system that pools funds to offer access to quality health services to all South Africans based on their health needs and irrespective of their socio-economic status.

It will need a massive reorganisation of the current health system, both public and private. The aim is to establish a fund that achieves sustainable, affordable and universal access to healthcare services.

How will it affect average South Africans?

Dr Anban Pillay, deputy director-general for health regulation and compliance in the national Department of Health, says universal health coverage is about ensuring all people have access to promotive, curative and rehabilitative health services, while ensuring people don’t suffer financial hardships in paying for such services. “It’s about leaving no one behind. A commitment to equality, no discrimination and a human rights-based approach to services,” says Pillay.

Will your current medical aid be affected?

Motsoaledi has indicated that government subsidies for civil servants and the schemes restricted to government employees would eventually be scrapped. However, those who can afford to pay for medical aids will have the option to top up.

How long until it comes into effect?

According to the NHI Green Paper, NHI will be implemented gradually in three phases over a 14-year period. The NHI Bill does not give an actual date of implementation.

The five-year pilot phase of NHI, however, was phased in in April 2012. The pilots were meant to serve about 10270000 people or 20% of the population. The National Treasury has allocated R1billion for the pilots in 10 districts in South Africa.

Motsoaledi said this week that the implementation of the NHI would take some time and would result in a massive reconfiguration of the country’s healthcare system. He has said that the NHI will not be an event for which there will be a date of implementation.

Interested parties have three months to comment on the bill, which was published at the same time as the Medical Schemes Amendment Bill.