Before the ink dried on Monday after President Cyril Ramaphosa announced he will sign the National Health Insurance (NHI) bill into law on Wednesday, there was a huge outcry from those opposed to the bill.
Some threatened to approach the courts to stop the implementation of the law.
In a pamphlet issued by the national department of health, one could see that the drafters of the bill have noble intentions in mind, the main one being to share the money available for healthcare in South Africa.
Government said in terms of the new dispensation, all hospitals, clinics, doctors, specialists, dentists, nurses and all other health professionals will be available to provide services to all much more equally.
It said the NHI will create one public health fund with adequate resources to meet the needs of the entire population, not just a select few.
Government said private healthcare providers will continue to provide a service, but NHI will not allow them to charge the exorbitant fees they are charging today. It said under the NHI, private health service providers will no longer be allowed to charge extra cash called a co-payment after the NHI has paid them, as is currently happening.
Government said it was not true that the private health sector was working well because it was only serviced 16% of the population and excluded the majority. It alleged medical schemes were collapsing under the weight of medical costs and said it could not sit by and watch while a private health system could take a patient out of ICU simply because their benefits had run out.
On the face of it, the NHI wants to make good for the majority by ensuring that private healthcare funds go into the bigger NHI pot, for the benefit of all.
While these are very good intentions , critics of the legislation question whether the law is capable of being implemented.
The Health Funders Association, which represents 43% of the country’s medical scheme membership base, said a more collaborative approach between the public and private sectors was essential for achieving universal health coverage in a timely and effective manner.
It said an opportunity to review certain flawed sections of the bill has been missed. The HFA said it is prepared to defend the rights of medical aids and all South Africans to choose privately funded healthcare, where necessary.
However, not all medical schemes are totally against the NHI. Medihelp said the implementation of the NHI will rely heavily on the readiness of the existing healthcare infrastructure and the workforce, public education and the financial resources, which required many minds to address.
However, it still believes private and public healthcare systems can coexist successfully.
But what seems to be the biggest fear of those in the private sector is that the state, known for squandering of public funds in some instances, is likely to dip its hands into the bigger pot for nefarious reasons.
However, it cannot be business as usual that access to quality and affordable healthcare should be determined by one’s earning potential, in a country which has the highest inequality in income distribution.
Who can forget the corruption on a large scale at Tembisa Hospital, where the Special Investigating Unit is probing payments of more than R1bn to companies that grossly overcharged for products?
However, this is not a challenge affecting only the pubic health sector. There are reports of how patients and health workers falsely claim money from medical aids in the private healthcare sector.
The Bhekisisa Centre for Health Journalism said in a recent report that fraud costs the public health industry up to R28bn a year, according to the Council for Medical Schemes.
Despite the passage of many years of this bill into law, government can still negotiate with all those who provide private healthcare services to ensure that the proposed insurance scheme is workable, and that resources are not wasted.
However, it cannot be business as usual that access to quality and affordable healthcare should be determined by one’s earning potential, in a country which has the highest inequality in income distribution.
