If the country is to reduce its high cancer statistics, the public would have to be educated about the illness and preventative measures taken, says Gauteng Health MEC, Dr Gwen Ramokgopa.
Ramokgopa was speaking at the launch of the state-of-the-art Lung Laboratory at the Helen Joseph Hospital, in Johannesburg.
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1. Will you be able to say “thanks, but no thanks”?
If the National Health Insurance (NHI) Bill is passed in its current form, the NHI will be compulsory, regardless of whether you also belong to a private medical aid. So, opting out won’t be possible. The Bill says the NHI, which will be like a big, state-funded medical scheme, will be a free service, but it doesn’t tell us what benefits will be covered, how the scheme will be paid for or how much it will cost.
2. When will the NHI start, and, will it actually happen?
The NHI Bill says the scheme will be implemented in three phases — we’re currently in the second phase (2017 – 2022), during which NHI legislation has to be developed and the NHI fund has to be established. During the last phase, from 2022 – 2026, Cabinet has to approve “the mobilisation of additional resources” so that the NHI can start to buy healthcare services from both public and private providers
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The two fundamental issues with the new white paper on National Health Insurance (NHI) are a single payer fund and the nationalisation of private healthcare without compensation.
Single payer fund
In terms of the single payer fund, the white paper believes that the NHI can use bulk purchasing power to drive down the price of healthcare services. However, it then simultaneously declares that it will accredit medical service providers – public and private – and then set the prices at which they can sell their services to the NHI. It specifically states that it will deploy a “uniform reimbursement strategy” and that accredited service providers will not be allowed to deviate from that.
This raises a fundamental question. If the NHI is going to regulate the price at which the services are being procured, why does it need to use the bulk purchasing power of a single fund to reduce prices?
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The latest iteration of the National Health Insurance (NHI) policy paper is no closer to defining how much the scheme will cost and where the money will come from to pay for it.
Meanwhile, SA risks running out of tax payers to finance its social security commitments, said Dr Johann Serfontein, senior healthcare consultant with HealthMan and Jasson Urbach, director & head of the Free Market Foundation’s Health Policy Unit.
The NHI scheme is based on a government administered, centrally controlled, single-payer model. Healthcare decisions will be determined by government from the cradle to the grave. NHI will reduce the number of available services, mean fewer healthcare providers and patients will face long waiting lists. NHI concentrates power in the hands of government and requires it to act as both player and referee, leaving no room for the private sector. Under NHI, whether directly or indirectly, government will control the availability, financing and
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In its current form, the proposed National Health Insurance (NHI) is by no means perfect and there remains a lot of uncertainty around funding, medical skills shortages, the role medical aids will play and how infrastructural problems, wastage and corruption in the public sector will be tackled.
“Healthcare reform challenges all of us that operate in the sector to keep and expand our place at the table. It is becoming increasingly clear, however, that NHI is here to stay, which makes it imperative for pharmaceutical companies to get involved in the debate at the highest level in order to help shape a sustainable and effective healthcare system for South Africa,” says Erik Roos, CEO of Pharma Dynamics…
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Has the almost simultaneous release of the National Health Insurance (NHI) Bill, the Medical Schemes Amendment Bill and the provisional findings of the Health Market Inquiry (HMI) created an information overload, where some of the insights from the inquiry could be lost in the noise?
“There is significant risk that the regulatory environment being created through the legislative amendment process currently underway could conflict with the lessons learned in the course of the HMI’s work, which will only be fully apparent on the release of its final report,” says Mark Arnold, principal officer of Resolution Health Medical Scheme.
A considerable amount of time, resources and expertise have been invested in the HMI, but with the final report due for release in November, however, there is a risk that the full benefit of these insights could be lost due to the timing of these inter-related developments, as the period for submissions on Medical Schemes Amen
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Two of the proposed amendments to the Medical Schemes Act will do away with co-payments, and abolish the practice of using brokers within the medical schemes environment.
Health Minister, Dr Aaron Motsoaledi, said co-payments mean that the scheme pays a portion of the bill that a provider – be it hospital or private doctor – charges to a patient. The rest of the funds are supposed to be paid by the patient from their own pocket.
“The amendment means that every cent charged to the patient must be settled fully by the scheme and the patient should not be burdened with having to pay. There are people who will scream that this amendment is outrageous and calculated to destroy medical schemes and leave beneficiaries with nothing. I want to assure you that this was well thought out,” he said.
According to data at the department’s disposal, medical schemes are holding close to R60bn in unused reserves. While there is a statutory requirement that me
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‘I can’t mention who are the parties I am expecting litigation from but I can assure I know who they are. Health Minister Aaron Motsoaledi is preparing to be taken to court as he continues to propose changes in the healthcare system that could cost medical aid schemes millions.
Motsoaledi introduced the draft Medical Schemes Amendment Bill and National Health Insurance (NHI) Bill in Pretoria this week. The new legislation proposes significant changes to the way healthcare is funded and managed, including abolishing co-payments, prescribed minimum benefits and waiting periods for medical aid cover.
Medical aid schemes currently hold about R 60-billion in reserve — an amount almost 10% higher than what is statutorily required, said Motsoaledi speaking at a Pretoria press conference.
“These huge reserves were accumulated partly through high premiums but also by introducing the co-payments such that medical schemes avoid having to pay or even dip into the
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The National Health Insurance (NHI) Bill of 2018 will be published in the Government Gazette shortly for public comment.
A key provision of the bill will be the establishment of an NHI fund to pay for health services so that all South Africans have access to quality care.
“The bill seeks to establish the NHI Fund of South Africa, as a public entity, so as to provide for a sustained universal health access that is affordable and of high quality. It also sets out its functions, powers and duties,” Cabinet said in a statement following its regular fortnightly meeting.
The bill provides a framework for the active purchasing of health care services by the fund on behalf of users and creates mechanisms for the equitable, effective and efficient use of the resources of the fund to meet the health needs of users.
Despite the Life Esidimeni tragedy, non-existent oncology services in some provinces, striking healthcare workers and a damning quality standards report before parliament, Health Minister, Dr Aaron Motsoaledi seems to be labouring under the delusion that the South African public healthcare system is not collapsing.
Speaking at a media briefing, the minister said he was not aware of any scientific methods used to measure the veracity of the claims made about the breakdown of the health system.
“I am not here to challenge that because I do not know the yardstick that was used to arrive at a conclusion of collapse. Surely healthcare systems are measured on some form of scientific yardstick to arrive at any conclusion.”
The latest iteration of the National Health Insurance (NHI) policy paper is no closer to defining how much the scheme will cost and where the money will come from to pay for it. Meanwhile, SA risks running out of tax payers to finance its social security commitments, said Dr Johann Serfontein, senior healthcare consultant with..
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