The Health Professionals Council SA (HPCSA) has stated in a presentation given to Parliament, that all Medical Scheme reserves should be moved over to the National Health Insurance (NHI) and for the Medical Schemes act to be eliminated.

How the NHI is to work if this is passed

• The NHI will be the sole funding mechanism for health and will take over all assets under the control of medical schemes.

• The NHI will be funded by tax coming from all employed South Africans.

• All private medical schemes will still be allowed to carry on, although it will only be on a medical insurance basis for additional cover and will be funded separately over and above the tax paid to the NHI.

• The future role of medical schemes will be controlled under the Insurance Act and they should only offer complimentary coverage to services not covered by the NHI

NHI plan progress

• The plan is in full development and is said to go into phase 3 in the next year – 2021 / 2022.

• The Council for Medical Schemes (CMS) advises that phase 3 will include the finalisation and implementation of the NHI Act, as well as the contracting for accredited private hospital and specialist services and a mandatory pre-payment of new schemes.

The challenges

• The Board of Health Care Funders (BHCF) has voice that they expect there to be some challenges with the NHI, some of these being the following:
  • Healthcare service providers
  • Members of the public due to there being some restrictions of choice
  • Possible corruption in the NHI
  • Some of the functions in the Bill which includes duplications and unnecessary costs from contracting units for primary healthcare services

• The BHI states the NHI fund needs to be accountable at three different levels to ensure viability and sustainability:
  • The fund must be accountable to the Prudential Authority. This authority was created by the Financial Institute Regulations act that sits within the SA Reserve Bank
  • Accountability to Parliament
  • Accountable to the Minister of health in accordance to the Public Finance Management Act

South African Nursing Council (SANC) chairperson Raesetja Molepo said the council was in support of the Bill. However, “emergency medical services should be redefined as emergency health services to include emergency health services provided by all health professionals, doctors, allied health practitioners, including nurses. Healthcare professional should be defined to mean any persons registered with the health statutory councils in South Africa”, Molepo said.

Health Minister Zwelini Mkhize announced that R7.5 billion has already been allocated to NHI unit and that the implementation remains government’s main objective. The funds allocated are to be used for medium-term expenditure to strengthen the system and to get service providers onboard.

Sources:

Medical Brief  

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