SA’s key association for organised business says it is encouraged by the government’s “openness to engage” on the National Health Insurance (NHI) Act and will at the president’s request submit a proposal to address its concerns.
The leadership of Business Unity SA (Busa) met President Cyril Ramaphosa, health minister Aaron Motsoaledi, his deputy Joe Phaahla, and senior officials from the presidency and the Department of Health on Tuesday to discuss the contentious legislation.
“We have made it very clear that there are sections of the Act we are not happy with. We would like to engage and see if we can reach agreement on some amendments to those sections,” Busa CEO Cas Coovadia said on Wednesday.
Busa said its primary objective was to “render the NHI Act workable, affordable and implementable, while advancing universal health coverage and ensuring an equitable healthcare system for all”.
The NHI Act sets in motion sweeping reforms intended to achieve the ANC’s plan for universal health coverage, which aims to provide eligible patients with care that is free at the point of delivery. The act paves the way for the establishment of a government-controlled NHI fund that will purchase services from accredited public and private providers for eligible patients, and says medical schemes will ultimately be restricted to offering cover only for services not provided under NHI.
In addition to discussing potential amendments to the Act, Busa has proposed the government consider other measures to improve access to healthcare, such as those flighted by Netcare CEO Richard Friedland at a recent private hospital industry conference, said Coovadia.
In a presentation on behalf of the Hospital Association of SA, Friedland said introducing mandatory medical scheme membership for everyone in formal employment along with a risk-equalisation fund to level the playing field between competing schemes could triple the size of the medical scheme market.
Increased membership
The number of medical scheme beneficiaries could increase from 9.2-million beneficiaries to 27.5 million and reduce the number of people who rely on the public sector from 53.8 million people to 35.5 million, he said.
Most people who use private healthcare services pre-fund their care by belonging to medical schemes that pool members’ contributions. However, a significant number of people who do not belong to medical schemes also use private healthcare services — mostly for GP and hospital visits — and pay out of pocket.
Stats SA’s 2023 General Household Survey found 26.3% of the population turned first to a private healthcare provider, a figure considerably higher than the 15% of the population that belongs to medical schemes.
Busa has consistently said it supports the goal of universal health coverage, but is concerned about the NHI Act’s potential impact on health care, taxpayers, the economy and investor confidence. It made numerous submissions during various public consultations undertaken by parliament when it considered the legislation, which were largely ignored.
In a statement issued on Tuesday night, the presidency said the government remained committed to engaging with all stakeholders on health reform and to “finding workable solutions that will advance quality and affordable healthcare for all”.
Update: September 18 2024
This story includes comment from Business Unity SA and additional information on medical schemes
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