Minister of Health Dr Aaron Motsoaledi File picture: Jacques Naude/African News Agency (ANA) Archives
NOW THAT Health Minister Aaron Motsoaledi has gazetted the National Health Insurance Bill, he is yet to reveal where the money will come from.

Motsoaledi yesterday said the primary objective of the long-awaited bill was to ensure that every South African had access to the public and private health sectors without any prejudice.

But some have questioned the necessity of the NHI as the public healthcare system struggles.

“The NHI is simply not feasible. We have seen how NHI pilot projects across the country failed dismally," the DA’s member of the health portfolio committee, Lungiswa James, said.

"Doctors and pharmacy assistants contracted to assist with NHI projects have allegedly not received salaries from the Department of Health’s payroll administrator"

The DA would continue to expose the NHI for what it truly is - unaffordable, impractical and unfair, she said.

But Motsoaledi, facing a barrage of criticism over the past few months over his handling of the health portfolio, yesterday turned his focus onto the medical aid sector, saying healthcare would no longer favour the wealthy.

On several occasions, the sector has come under fire for charging high fees to subscribers.

Motsoaledi said the National Health Insurance would change this.

He announced in Pretoria that his department was now inviting the public to comment on his proposed Medical Schemes Amendment Act and the NHI Bill which have been approved by the cabinet.

In his proposed amendments, Motsoaledi calls for the abolition of medical aid co-payments and prescribed minimum benefits, and unequal and unfair benefit options offered by schemes.

On average, comprehensive medical aid cover costs middle-income households anything between R1000 and R4000 a month, he said.

The World Health Organisation and Organisation for Economic Co-operation and Development have revealed only 10% of South Africans can afford private healthcare.

Motsoaledi said data seen by his department showed that medical aid schemes were holding reserves of close to R60billion which had not been used. These reserves were accumulated through the schemes charging high premiums.

Complaints received by the national Health Department and the Council for Medical Schemes warranted the amendments sought.

“The amendment means every cent charged to the patient must be settled fully by the scheme. The patient shouldn't be burdened with having to pay."

The new medical aid system, under the NHI, would do away with brokers being paid R2.2billion monthly to ensure people had access to medical aids, he said.

Previously health officials cited the dilemma the public healthcare system faced due to private patients flocking to hospitals once their medical aid funds had been depleted.

Motsoaledi was at pains to detail how the NHI would succeed amid the turbulence his state hospitals and clinics faced.

He maintained that the primary objective of the NHI Bill was to ensure every citizen in South Africa had access to the public and private health sectors without prejudice.

“We are painfully aware that some believe that even before we open our mouth about NHI, we must fix the ailing public healthcare system first.

“We are very much alive to the problems of poor quality and lack of efficiency in the public healthcare system. That is not a matter of debate. Fixing the quality of public healthcare is an ongoing, continuous process"

He attributed current problems to “deep-seated problems” in the private health sector, flagged by the National Development Plan (NDP).

The NDP urged all to deal with the high cost of private healthcare and the poor quality of care in the public health system.

The Board of Healthcare Funders of Southern Africa (BHF) said it supported the proposed amendments.

BHF represents 45 medical aid schemes in the country and an additional 23 other schemes in several other African countries.

“As an industry representative body, we support the intention and action aimed at ensuring that the greater population of the country receive quality healthcare,” its chairperson Dr Ali Hamdulay said.

He warned the private sector it was not immune to the proposals. It had an equal duty to provide affordable health services.

The South African Communist Party also welcomed the bill, saying it came at a time of growing concerns over the affordability of medical aid schemes.

“South Africa must roll back the dominance of medical schemes in healthcare financing through the creation of a single NHI Fund.”

The National Education, Health and Allied Workers’ Union also welcomed the bill, but was concerned that Motsoaledi had released the Medical Scheme Amendment Bill before the findings of the Health Market Inquiry had been made known.