The National Health Insurance (NHI) Bill is so deeply flawed that if it is implemented in its current form, it will hinder rather than achieve the government’s ambitions for universal health coverage, SA’s biggest industry association for medical schemes warned on Thursday.
The Board of Healthcare Funders (BHF), which represents medical schemes and administrators, said NHI as envisaged in the bill threatens the sustainability of private healthcare providers and is at odds with the constitution.
Its concerns echo those expressed recently by big business and SA’s biggest medical scheme administrator Discovery Health, which all complained that parliament’s health committee approved the bill without any substantive changes, despite input it received from stakeholders ranging from JSE-listed companies to health activists.
The bill provides for establishing a NHI Fund, as sole purchaser of health services for SA citizens. The services will be bought from accredited public and private healthcare providers, and will be free at the point of delivery.
The scheme is based on the principles of social solidarity, in which the rich and the healthy subsidise the poor and the sick, but government has yet to set out how it will be financed. The private sector’s biggest concern is the future role of medical schemes: section 33 of the bill says they may cover only services not provided under NHI.
Parliament’s portfolio committee approved the bill on health in May. It is expected to be passed by the National Assembly within the next few weeks. It will then be sent to parliament’s second house, the National Council of Provinces (NCOP), where legislators will conduct a fresh round of public consultation with provinces. Once the NCOP has completed its deliberations, the bill will be sent to the president to sign into law.
BHF MD Katlego Mothudi, said the bill imposes significant restrictions on where healthcare professionals may practise, as they will be required to be accredited by the fund and contract with it. This interfered with their constitutional rights to practise their profession, he said.
The BHF said the bill’s provisions on the role of medical schemes were unconstitutional as they restrict access to healthcare services. It is lobbying for a multipayer model, in which medical schemes coexist with the NHI Fund.
Given that it will probably be several years before NHI is implemented, the BHF is pushing several initiatives aimed at improving access to healthcare, said Mothudi. These include an exemption application to the Competition Commission to allow healthcare providers and funders to engage in collective bargaining on tariffs, and legal action against the Council for Medical Schemes on delays in implementing low-cost benefit options.
These are pared down medical scheme benefit packages focusing on primary healthcare services and offering significantly less cover than required by the Medical Schemes Act.
Would you like to comment on this article?
Sign up (it's quick and free) or sign in now.
Please read our Comment Policy before commenting.