South Africa National Healthcare Bill

South Africa’s NHI Bill – How it will affect you

Have you heard the news? By the year 2026, South Africa’s National Health Insurance Bill will be in full swing. Finally! Every South African will be entitled to free, world-class health services.

Great news! 

Or is it?

At the moment, South Africa’s healthcare is being financed by medical schemes and hospital cash plans but these only benefits those who are employed and fall within the middle- and upper-class income groups; those belonging to the lower-income groups are left to fend for themselves should they need medical attention.

Around 84% of South Africans currently rely on the country’s public health system, some of whom wait up to 5 years to receive lifesaving treatment.

In theory, South Africa’s National Health Insurance (NHI) Bill sounds ideal – it aims to provide every South African with access to quality health care services, but is it really that clear-cut?

Let’s take a closer look at how it will work.

As a medical aid member, you are currently paying a monthly membership fee. But under the NHI bill, you will see a similar amount added to your tax contribution each month. Medical aid schemes as we know it will (allegedly) become obsolete and South Africa will be left with one health system (instead of our current 2-tier system). 

Although, according to a Q&A released by the South African Health Department, “it is not the intention of Government to abolish private medical schemes if individual members wish to keep them. However, once NHI is implemented, it becomes mandatory for all citizens, meaning no one can opt-out of it even if they still wish to keep their private medical aids schemes”.

Most health care services such as GP visits, prescription medication, surgery, and in-hospital stays will be free of charge and registered doctors will be paid by the South African government.

The bill was first introduced in August 2011 and is expected to be in full swing by 2026, but it’s being rolled out in three phases:

Phase 1: (2012 – 2017) The foundation is laid for the NHI Bill. The NHI fund was introduced and tested in 11 health districts.

Phase 2: (2017 – 2022) Focused on ensuring the bill is functional and the required management and governance structures are in place so that the acquisition of services and registrations can begin.

Phase 3: (2022 – 2026) Mandatory prepayment will be introduced to the public, the services of private hospitals and specialists will be contracted, and the Medical Schemes Amendment Act will be finalised. 

We are currently in the second phase, waiting for the 3rd and final phase to begin in two years.

The government says that the NHI is aimed at helping medical aid members cope with expensive out of pocket costs. But will the quality of our healthcare have to suffer for the sake of affordability? 

Not according to SA’s health department. It says that the NHI bill will see massive investments made to ensure the improvement of the country’s health infrastructure and the following standards must be complied with –

  • Improved hygiene within hospitals
  • Reduced waiting times
  • The elimination of stock shortages (medicine will always be available)
  • Improved safety measures for both patients and staff
  • Added measures to prevent in-hospital infections due to negligence
  • Friendlier and more competent staff

These seem to be targeting the correct pain points currently faced in our public hospitals. Especially when it comes to waiting times, hygiene, and staff competence.

Is it such a good idea to merge SA’s 2-tier health system, though? We’ll let you decide. 

The Pros

  • Everyone, regardless of income, will have access to proper health care.
  • All contributions, along with funds from the country’s healthcare budget, will be combined to pay for health care services meaning that doctor’s consults and treatment will be more affordable
  • You will have access to all your medical records.
  • You will have access to specialists you would otherwise not be able to afford, and
  • Inequality within the healthcare industry will decrease and ideally, be eradicated.

The Cons

  • If you receive an income, you will have to contribute to the NHI fund. 
  • As an SA citizen, you will be required to join the NHI fund, it is mandatory
  • Foreign citizens won’t be covered unless they have travel insurance
  • You will need to adhere to strict rules should you need to visit a specialist
  • You will need to register with a GP who is contracted with the state
  • There will be a tax increase for all employed citizens
  • Unless you are still registered with a private medical aid scheme or are willing to pay cash, you will need to choose from a list of registered GPs.

The Bottom Line

The overwhelming opinion is that the National Health Insurance Bill will do more harm than good by not only harming the country’s private health sector and medical aid schemes, but also damaging South Africa’s economy as a whole.

There are still some grey areas in the bill but ultimately, the NHI Bill will be implemented despite public protest. The question of how successful this system will be remains to be seen.

Get in touch and let us know how you feel about this new bill. 

Are you getting the best deal possible with your medical aid? Visit the website to view your medical aid options or request a call from one of our expert consultants.