Medical aids will be allowed, but their role will change with NHI: Zweli Mkhize

Medical aid schemes will be allowed to exist when National Health Insurance is rolled out, after employers or employees have paid their premiums for the fund, says health minister Zweli Mkhize.

He also said that the private medical industry was lobbying against NHI but he would not allow them to derail it

"Are you saying because of private self-interest, must we compromise the lives of South Africans?"

Mkhize was talking at a presentation that discussed a detailed report giving feedback on 11 NHI pilot projects that showed mixed success and failure.

Mkhize told the Board of Healthcare Funders conference this week that the role of medical aid schemes would change with NHI.

He was asked multiple times at the Friday event if medical aid schemes would still be allowed to exist. He said first and foremost the NHI single fund would buy services for the whole country. The medical aids could step in. "Are we banning medical aids? No. That role is going to keep changing as NHI opens up right now. We are engaging with medical aids. We will change the way medical aids work."

He added: "What we envisage is health care for all South Africans will come from National Health Insurance."

However, he said people with private healthcare could not see a specialist if they wished to for no good reason. He complained that many people visited specialists for treatment that GPs could give. Instead, specialists needed to treat the sickest South Africans, he said.

"It is not my right to see a specialist because I can afford it. It is a distortion of how the system should be working."

He said the key part of NHI was for "social solidarity", meaning the rich helping the poor and the healthy subsidising the sick.

He said the "totality of resources must be available to help those who are sicker".

"Those who are poorer must have equal access to [health as those who are] healthier and wealthier … This socialised system is being used in many countries."

Asked about the fact that there was already "social solidarity" at play in the health system with many taxpayers subsidising the cost of state care for others and buying their own private care, he became visibly frustrated. He said the media had asked too many questions about medical aids.

"Let’s try and separate the issue of medical aid … we are not going to be bogged down on one issue … by medical aids. Their roles will be evolving."

"The issue of pretending that is everything in private care and medical aids are rosy is not correct."

The minister added: "Some people say NHI is unaffordable. What is unaffordable is the rising cost of [private] care."

He also said there was a lot of lobbing by medical aids who wanted to block the progress of NHI. But he admitted the public sector was characterised by "corruption" and "mismanagement" and poor quality and he repeatedly said it needed to be fixed.