Have your say on the NHI

Thursday, August 8, 2019

Health Minister Zweli Mkhize has called for robust debate on the newly released National Health Insurance Bill.

“As a department, we look forward to the robust debate that will surely come - as far as we are concerned all the hard questions only deepen our knowledge and understanding of the nation we intend to serve and sharpen our acumen for the policies we intend to implement,” said the Minister.

The Bill, which was signed by Mkhize and adopted by Cabinet in July, was officially released by Parliament on Thursday.

Mkihize officially announced the Bill at a special media briefing held at the Southern Sun Hotel in Pretoria.

Through the NHI Bill, government seeks to fulfil its constitutional obligation to provide quality universal health care for all as envisaged in Section 27 of the Constitution and the United Nations Sustainable Development Goals.

The introduction of the Bill to Parliament begins the vigorous legislative process where the National Assembly and the National Council of Provinces engage the Bill in pursuit of the mandates as set out by the Constitution.

The Bill is based on the principle of “social solidarity” where healthcare users look after each other in times of medical need.

“For too long has our health care system operated in an unsustainable and unjust manner. The public health care system shoulders the lion’s share of disease burden in this country, looking after 84% of our population with less resources than the private health system that services only 16% of the population,” said the Minister.

The public engagement process encompasses 61 steps of engagement and re-engagement, including that of public consultation.

Who will be covered under the NHI?

Under the NHI, South African citizens, permanent residents, refugees, inmates, designated foreign nationals and all children will receive primary healthcare.

Aslyum seekers, illegal immigrants and foreigners with no travel insurance will only receive limited coverage through emergency medical services.

Foreigners who hold travel insurance will be covered by their own policy.

Primary healthcare centres such as clinics or general practitioners will be the first point of access to healthcare. 

Access to healthcare services will be provided free of charge at healthcare facilities.        

How does the NHI work?

Through the NHI, a patient will be registered as a user. Users will be required to approach primary healthcare facilities such as a clinic or general practitioner who will serve as the first level of entry to healthcare.

Once at a primary healthcare facility, the healthcare practitioner will determine the level of care that is necessary for the patient and if necessary refer the patient for further treatment.

Patients will receive this treatment for free but should a patient directly approach a specialist they will forfeit the free treatment and pay for the service.

What happens to medical aid schemes?

Under the bill, medical aid schemes will gradually be phased out until they –as the main source of primary healthcare -ultimately cease to exist.

Medical aids will thus only be able to provide what is called a complimentary cover. Complimentary cover will provide services that are not listed under the NHI such as cosmetic surgeries for instance.

The Health Department forecasts that the NHI will be fully implemented by 2026.

Once fully implemented, the NHI will offer what is noted as “comprehensive healthcare services” but will exclude what the bill notes as “complimentary services”.

Complimentary services will include health services such as cosmetic surgeries.

Through the complimentary services cover, medical aid schemes will still be able to provide healthcare that is not covered under the NHI.

“The Medical Aid industry will have no trouble adapting to the changing environment, as they have successfully done in the past, by developing financial products and services that provide complementary cover.

“All South Africans will benefit from high quality health care without the burden of out of pocket expenses,” said Mkhize. – SAnews.gov.za