Women to directly benefit from NHI

Friday, August 9, 2019

Women and girls will be direct beneficiaries of the newly announced National Health Insurance (NHI) Bill.

This is according to President Cyril Ramaphosa who led the national Women’s Day commemoration event in Vryburg, North West on Friday.

2019 marks the 63th anniversary of the 9th August 1956 Women’s March against pass laws.

“We are going to ensure that women and girls are direct beneficiaries of the National Health Insurance once it is implemented.

“All of these interventions are to ensure the women of this country are healthy, that their needs are responded to, and that the doors of opportunity are opened to them,” said the President.

Just over two weeks ago, President Cyril Ramaphosa signed the Presidential Health Compact with stakeholders across the health sector on a series of measures to significantly improve the quality of the health care for all South Africans.

The Compact, forms part of government and stakeholder efforts to pave the way for 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. – SAnews.gov.za