NHI needs combined private, public efforts

Wednesday, September 2, 2009

North West - Realising the National Health Insurance (NHI) principles of universal coverage can be made easier by combined efforts of the private and public sectors, says Deputy Minister for Health Dr Molefi Sefularo.

Addressing a Board of HealthCare Funders Conference on Wednesday, the deputy minister said there needed to be a sharing of experiences and technical expertise from both the private and public sectors.

"It is only through working together that we can create a health system that is truly world-class, offers our people adequate and reliable financial risk protection and access to affordable, acceptable and equitable health services through an integrated network of public and private providers and facilities that offer good quality care to all," Dr Sefularo said.

He said the government was convinced that the private sector had an essential role of sharing their experiences with government on their achievements and challenges in the management and administration of private health insurance schemes.

"This is necessary to ensure that the publicly administered and managed NHI fund is appropriately poised to gain from the experiences of the past and to learn how to best address the challenges that it may encounter, especially with regards to controlling
costs escalation, managing and preventing fraud among other things," he said.

Dr Sefularo said it was time for government to take a leadership role in the functioning of the national health system through the creation of social safety net.

He said this "net" would ensure that people have financial risk protection from catastrophic healthcare expenditures and enjoy access to good quality and affordable health services when they need it.

"This is what forms the basis of the proposal to implement a NHI in the country," he said.

The deputy minister reiterated that the broad objective of pursuing a NHI was to ensure that the majority of the country's health funds flow through the NHI, which will enable all South Africans to access quality and comprehensive health services, which will be free at the point of service.

"It is within this context that the present dominant role of medical schemes in health care funding needs to be reviewed, the current concentration of health care resources in one sector that benefits the few is not what we envisage.

"The proposed NHI model calls for key adjustments that have to be made in the national health system in relation to four equally important areas, namely the revenue collection and pooling of funds, purchasing of services and the provision of these services to the general public," said Dr Sefularo.

He further explained that National Treasury and the South African Revenue Services would take a lead in advising the government on the best funding mechanism.

"Innovative mechanisms are being considered with regards to the processes of quality assurance and quality improvement systems to ensure that these two core elements become inculcated as routine processes that will help ensure sustained quality improvement and assurance in both the public and private health facilities," Dr Sefularo said.

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