OPINION: NHI Bill's intentions noble, but collaboration necessary

By Lee Callakoppen Time of article published Aug 28, 2019

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The National Health Insurance Fund (NHI) Bill was released on August 8. Bonitas Medical Fund welcomes the efforts of the Department of Health insofar as it aims to achieve sustainable and affordable universal access to quality healthcare services for all South Africans, and we are in full support of the intent towards universal healthcare.

We note the detail that has gone into the bill and have embarked on a comprehensive review. As a fund, we view this as a positive milestone that will allow debate and engagement between all stakeholders to strengthen the healthcare system.

South Africa's healthcare system remains highly unequal.

When expressed as a proportion of gross domestic product, about the same amount of money is spent on catering for the 16 percent of South Africans who belong to a medical scheme as is spent on the other 84 percent who rely on the overstretched public health system, according to a review of World Health Organisation data recently published by the Mapungubwe Institute for Strategic Reflection.

The reality is that many South Africans use both the public healthcare sector and the private healthcare sector, thus the number of people who belong to a medical scheme does not equate to the number of people using the private health sector. The converse is also true, with some medical scheme members using public hospitals or state clinical protocols for the treatment of specific conditions, such as tuberculosis.

We have always supported the intent of universal healthcare and believe that it is in the interests of the greater good of everyone - and not only the 16 percent of the population who belong to medical schemes.

For the NHI Fund to be a success, collaboration between medical schemes and the government is essential. There are various aspects to consider when it comes to the bill, but, most importantly, central to it all is the impact on its users - South Africans.

We also note that the bill outlines a transitional arrangement. This is a positive, because the rollout of NHI will not happen overnight. There is much work still to be done, beginning with the process of stakeholder engagement and debate if we are to work towards implementing universal healthcare in accordance with our Constitution.

It's important for all stakeholders - including civil society - to participate in these processes to ensure a fair, participatory and transparent process that will lead to a reasonable NHI Bill that will ensure a sustainable, workable, stable and quality healthcare industry.

Bonitas is evaluating the full NHI Fund Bill and will continue to provide insight and comment to ensure that South Africans’ access to healthcare is enhanced.

Lee Callakoppen is the principal officer of Bonitas Medical Fund.


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