Tag: NHI

Categories : Medical IndustryTags :

Financial Feasibility of NHI Challenged

On By ModernMedia
Photo by cottonbro from Pexels

Health groups are seeking detailed information on the workings of South Africa’s new National Health Insurance (NHI) scheme, particularly on its financial feasibility.

The Khayelitsha and Klipfonetin health forums said in a presentation to parliament that a proper analysis is necessary to see if South Africa can even afford to fund the NHI. This is a concern that has been echoed by experts. The analysis should also find out if the public trusts the government to be able to deliver an NHI that is fully inclusive of community participation, the forums said.

“There is a view that perhaps we need to be building our public healthcare system as a priority to ensure a successful transition to an NHI Fund,” it said.

The forums also raised concerns around what the NHI will mean for existing healthcare systems – including the future of the country’s medical aids.

“Clarity is needed with respect to how the NHI Bill will address the transition between private medical aids and a universal healthcare system for all.

“The gap between private and public healthcare needs to be bridged and how this is done is important.”

Other critics have also pointed out that the scheme does nothing to address the serious gaps and flaws in South Africa’s healthcare system.

The fate of medical aids

The NHI Bill currently states that when the system is “fully implemented”, services that are paid for by the NHI will not be covered by medical aids.

Discovery Health has said that while it is in general supportive of the structural changes being introduced through the NHI, medical aids should not be limited.

“Our strong view is that limiting the role of medical schemes would be counterproductive to the NHI because there are simply insufficient resources to meet the needs of all South Africans.

“Limiting people from purchasing the medical scheme coverage they seek will seriously curtail the healthcare they expect and demand. It poses the risks of eroding sentiment, and of denuding the country of critically needed skills, and is impacting negatively on local and international investor sentiment and business confidence.”

Crucially, by preventing those who can afford it from using their medical scheme cover, and forcing them into the NHI system, this approach will also have the effect of increasing the burden on the NHI and will drain the very resources that must be used for people in most need, the scheme said. Significantly, there is no indication by government as to how the NHI will be paid for, or whether it can even be afforded, with only mention made to payroll taxes and other revenue streams being tapped.

Source: BusinessTech

Categories : HospitalsTags :

SA Medical Insurance Schemes in the Crosshairs

On By ModernMedia

The Health Professions Council (HPCSA) said that South Africa’s new National Health Insurance (NHI) should be the sole funding mechanism for health in South Africa.

Addressing parliament on Tuesday, the president of HPCSA, Professor Simon Nemutandani, said that while the organisation accepts that the existence of private medical aid schemes in South Africa can continue, they should funded separately — over and above tax paid for the NHI.

The NHI itself should be funded through taxes paid by all employed South Africans, he said.

“For the NHI to succeed, health must be an exclusive national competence – and any sections of the Constitution that militate against this view must be amended,” the HPCSA stated.

“The Medical Schemes Act must also be amended to ensure alignment with the NHI. NHI should be about funding and contracting, while service provision is left to other entities — public and private.”

Prof Nemutandani said that the NHI Bill should repeal the Medical Schemes Act in its entirety, as the nationalised, centralised health funding system would have no place for it.

For those seeking additional insurance for health cover, they could apply for it under the Insurance Act. Medical schemes should also offer only complementary coverage for services that would not be covered by the NHI, he said.

Additionally, the current reserves of medical schemes — some R90 billion — and all other assets under their control should be transferred to the NHI, said Prof Nemutandani.

“It should be clear that the (NHI) replaces all funding mechanisms for health,” Prof Nemutandani said. “It must also be clear that the NHI is taking over from the medical schemes, and that all assets under the control of the medical schemes must be taken by over the NHI.”

Problematic aspects

The Board of Health Care Funders (BHF) said in its submission that current medical cover providers should be allowed to continue as insurance products. They also pointed out that a number of the Bill’s aspects are problematic, including a provision in the Bill transferring powers and duties of provinces to national government.

The BHF also expected there would be challenges from healthcare service providers and from members of the public over restrictions of their choices. Duplication of services and waste was another concern.

The NHI Bill was presented to and approved by cabinet in July 2019, and has been presented to parliament’s health portfolio committee.

Since then, it has been through an extensive public consultation process through committee roadshows and is scheduled for further parliamentary debates before being presented to the president for promulgation.

However, the Council for Medical Schemes has acknowledged that South Africa’s current financial situation and the impact of the COVID lockdown will make the rollout of the new NHI more difficult.

Source: BusinessTech

More information: Summary of all submissions (PDF)