The national Health Institute has proposed a new bill that will bring drastic changes to the medical landscape of South Africa. Although there are still significant details that need to be finalised there are changes ahead that all South Africans need to be aware of. While we attempt to demystify the new NHI Bill, what is most important to take note of is that these changes will be implemented in a staged manner with the intention to be fully implemented by 2026.
Everything you need to know about the new National Health Insurance Bill
The National Public Health Institute has proposed a new bill that will bring drastic changes to the medical landscape of South Africa. Although there are still significant details that need to be finalised, there are changes ahead that all South Africans need to be aware of. While we attempt to demystify the new NHI Bill, what is most important to take note of is that these changes will be implemented in a staged manner with the intention to be fully implemented by 2026.
We urge South African’s not to panic and make drastic changes to their medical scheme policies. Werner Coetzer, CEO of medicalaid.co.za, has this to say:
“Although reform of our existing healthcare system is necessary, South Africans should not spend their energy worrying about the new NHI Bill. They should rather focus on ensuring their existing healthcare spent is optimised according to their unique needs.”
The first question you might ask is, what will happen to my existing medical scheme? You may keep your medical scheme; however, the Bill proposes that medical schemes may no longer be authorised to cover anything the NHI covers. All South Africans will therefore rely on their medical schemes to assist with the medical needs the NHI does not cover. The Bill makes provision for cover access via authorised referral pathways; if these pathways are not adhered to, the Fund will not cover services. This means that for all practical purposes, schemes will be able to cover services in this instance.
At a recent conference held by the Hospital Association of South Africa, Dr Anban Pillay, Deputy Director General for Health Regulation and Compliance with the country’s National Department of Health, was quoted as saying that people will still be able to choose whether or not to make use of the NHI and will still be allowed to seek private medical solutions. The catch is that regardless of choice, there will still be a requirement to contribute to the NHI through taxes.
So, if the NHI doesn’t cover everything, what will it cover?
Since the new NHI Bill is still in the early phases of its implementation it is unclear what the Bill is going to cover. It has been stated that “comprehensive healthcare services” will be provided free of charge and there will be no co-payments. The new NHI Bill has stated, however, that there will be no financial assistance for conditions where “no medical necessity exists for the healthcare service in question”.
What does all of this mean if I need to see a specialist?
The Bill could be interpreted that by using the proposed referral pathways, access to specialists is possible, although how, who and where is unclear. Despite your having to pay a rather hefty tax contribution to support the new NHI Bill, it is strongly advised that you keep your medical scheme. While the exact tax contribution that will need to be made has not been finalised yet, it is important to note that there are still options for South Africans when it comes to medical schemes.
The new NHI Bill has been heavily criticised and branded a profound ideology. In theory it suggests a larger percentage of the South African population will have access to healthcare, which is a concept being heavily emphasised to the public. President Ramaphosa had this to say about the new Bill,
“It provides for a number of key elements that we would put in place to meet the constitutional imperatives that we need to provide healthcare services to all South Africans, irrespective of their socio-economic background, within the available resources.” Some South Africans have predicted that this Bill will drive our doctors away to seek better salaries and working conditions, which will lead to a crisis in healthcare. There is also speculation that the concept of a single buyer of services proposed in the Bill will lead to corruption and ultimately failure of the health system in South Africa.
Despite the major concern of a brain drain, there are other concerns:
- The public healthcare system is already not functioning efficiently. Although National Health Insurance promises to address the situation, many feel there is not a solid enough foundation in the public healthcare system to sustain this zealous project.
- The state will prescribe doctors for South Africans, meaning they will be taking the choice of preferred health professionals away from South Africans.
- There will be a huge economic impact, which seems to have been overlooked. The NHI Bill will cause many individuals working in the private healthcare sector to lose their jobs. Medical schemes all over the country will take a hit too.
- Worst of all, to reiterate, there is a risk that the most talented and able doctors will leave the country in search of better prospects.
Despite the sceptics, many South Africans are relieved as the Bill promises to equalise access to healthcare. “I would like to say that the NHI is here to stay. Whether people like it or not, it’s going nowhere,” said Ramaphosa in his address at an African National Congress Women’s League event.
Not only will the NHI benefit South African’s who would not otherwise have access to healthcare, but it also prevents the exploitative cost of private healthcare in South Africa, with some doctors and specialists charging much higher rates than the prescribed medical scheme rates.
South Africans are worried about how this will affect the quality of medical care in South Africa, and the burning question is who is going to pay for all of this? Well, the taxpayers, of course. They will be charged an amount “in accordance with social solidarity” through income tax, payroll taxes from employers and employees, as well as a surcharge on personal income tax. Many of the existing grants currently in place will also now be contributed to the NHI’s overall fund.
South Africans have expressed sharp criticism about the new NHI Bill and have raised many concerns; however, this does not guarantee any changes to the NHI Bill being passed. The only thing we can do now is to evaluate our medical schemes and prepare ourselves for what is to come by making sure we are covered for the procedures and doctors not covered by the NHI.
“We at medicalaid.co.za are constantly monitoring the progress of the roll-out of the NHI and will make it our mission to keep South Africans informed and guide them in their future medical scheme decisions,” says Coetzer.
Comprehensive medical scheme comparison website www.medicalaid.co.za is a well-respected and trustworthy comparison site that reviews SA’s top medical schemes in accordance with the parameters you set.
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