Certain factors are likely to affect NHI South Africa. The National Health Insurance's success or failure will be dependent on some factors as analysts determine. 4 key driving forces have been pointed out as crucial in the direction that this project takes.
Even as the NHI Bill comes into effect, experts believe that the positive progress of the National Health Insurance in South Africa is going to depend on key factors that include the collaboration between private and public sectors, the availability of skilled workforce, funding, and proper management where corruption is not involved. At least this is what Nicholas Burger, a health care analyst with Frost & Sullivan says.
Everything you need to know about NHI South Africa
First things first, Minister Aaron Motsoaled has been instrumental in seeing the success of national health insurance. This is seen by how he has been at the forefront of putting in place mechanisms and structures to see its success. This started when he published the NHI bill and the Medical Schemes Amendment bill some time back. The National Health Insurance bill will help turn this into law.
So how will it work?
Further, the minister said that the National Health Insurance South Africa is a program that will come in handy, as it seeks to level the playing field when it comes to health care in South Africa for all citizens. What this means is that the rich will eventually subsidize the care for the poor and the young for the old. He mentioned that the plan is set to kick off in 2026.
Going by current statistics, only 16% of South Africans have private medical cover. The remaining depend on the public health system. What this means is that the majority of South Africans would not get medical help anywhere else except through public facilities.
When introducing the 2 pieces of legislation, the minister was keen to point out the fact that the NHI will bring about huge changes. He said it was going to cause,
''massive reorganisation of the current health system, both in the private and public sectors”.
While he did not point put clearly how this scheme would be funded to ascertain its success, he said that if the treasury was to decide that people would make contributions, they will have to do so, and it would be based on each person's affordability.
Going by the 2017 NHI white paper, the cost will go up to R256 billion in 2025/2026 if they are to be based on 2010 prices, which is more than the R110 billion spent in 2010/11. As such, Burger pointed out the likelihood of the program being funded through a mixed model where different sources of revenues will be used.
“It could require shuffling funds that are directed towards other programmes in order to satisfy parts of the NHI.”
The February budget reveals that the Treasury had allocated R4.2 billion to the NHI to last up to March 2021. However, the minister said that it is on the R60 billion in reserves piled up by the medical aid industry that he had his eyes on.
Advantages and disadvantages of NHI in South Africa
Needless to say, the underprivileged will be the people that benefit the most from this program. In fact, the minister refers to them as the biggest winners. However, the chances are that the rich are likely to raise complaints on the fact that they are already paying huge amounts of taxes as they choose private medical care.
On the concerns of making medical care systems redundant, the minister pointed out that the success of NHI will depend on the collaboration of the private and public sectors, and as such, this is not likely to occur. The truth is that there will always be the option to use the medical aid schemes if that is what you want.
“There will always be the option to use the medical aid schemes. They will obviously collaborate with government.”
So far so good. The reception of universal health care seems to be accepted as the Board of Healthcare Funders of Southern Africa welcomes the idea. This board is a representative of 45 local medical aid schemes. With such a huge representation positively welcoming the idea, the chances are that its success is definite.
However, the minister complained that the medical aid schemes are not taking anything to chance as they hold their cards close. It is especially challenging to get them to release comprehensive data on their clients and their healthcare records.
“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.”
This then translates to the inability of medical schemes to charge prevailing premiums causing medical schemes sector consolidation.
Another advantage that is intertwined in the scheme is the elimination of brokers. Close to 2/3 of principal members of medical aid schemes have to make payments to a broker. This is unknown to many members. In fact, in 2017 alone, these brokers got R2.2 billion. The minister said that the intention is to have such amounts go directly into the health care system to address the direct expenses in the sector as opposed to going to brokers who are not even needed.
The bill's amendment is also intended to regulate membership cancellations, not to mention the waiting periods between joining and accessing medical scheme benefits. This is going to be great news for South Africans as the minister said,
“Under the NHI, there will be no penalty related to late joining or age.”
Spouses of principals who retire or die before paying their premiums are going to be the major beneficiaries here as they will be protected by law.
How will it work?
According to Burger, every person and service provider will have to be registered with NHI. Members will access health care services upon registration. Once they are registered, they can then select a service provider within the system.
The major concern is going to be about the bureaucracy that the NHI will have. Even so, based on the example of already existing models from developing countries, a good number of these issues can be sorted out digitally. Botswana and Rwanda are great examples to look at.
Even as the National Department of Health works on delivering health care for South Africans, it seems like the NHI is the real deal. With the right support, South Africans are headed to the right direction as far as universal health care is concerned. With the critical components of the NHI South Africa addressed, this scheme is likely to yield positive results. Any issue that arises can always be sorted out.