Experts have mixed views on impact of proposed NHI

The government's proposed National Healthcare Insurance (NHI) scheme will not have a drastic impact on the membership or earnings of medical scheme providers, says Discovery Holdings CEO Adrian Gore.

"I think it (NHI) is coming. I don't think it will have a negative impact on our business. Discovery has evolved with the country, and I don't think you can build a great business hoping that others fail.

"You can't build a business relying on bad things happening," he said.

A key proponent of the NHI, the University of Cape Town's Professor Di McIntyre, has calculated that the proposed plan will shake up the medical schemes market, with 40% of members likely to opt out and rely solely on state services.

"Low-income medical scheme members will face an affordability problem. Some of them will drop out. At the upper end, people will be prepared to pay more to have both NHI and medical scheme membership," she said.

According to the latest data from Health Systems Trust, 16.4% of the population is covered by medical schemes. This equates to approximately 8.2million South Africans.

A 40% drop in membership will mean that close on 3.5 million members will leave medical aid schemes and rely solely on the NHI.

Dr Jonathan Broomberg, CEO of Discovery Health, questioned McIntyre's projections, saying it was "too early to make any predictions about medical scheme members dropping out until we have more information on the benefits of NHI, its funding and access".

But a leading healthcare analyst disagreed.

"If the NHI is implemented in its current form, and it works as planned, then medical schemes will no longer be needed in their current form.," the analyst said.

"They will become relatively small and they will be a preserve for the rich.

"Even in countries like England, the rich still continue paying for medical schemes. They are not necessarily buying better care, but they are buying the right to jump the queue," he added.

In a report released this week, Econometrix economist Mike Schussler said the NHI would require higher economic growth if it was to be both affordable and comprehensive .

"With the level of the GDP doubling in real terms every 10 years in a 7% per annum growth environment, the NHI discussion paper budget levels could easily be exceeded without placing any undue stress on the remaining spending power of the rest of the economy.

"However, a 7% (annual) growth scenario remains highly unlikely. As yet, no one has illustrated how the 7% growth rate is to be achieved," he said.