Court challenges to the National Health Insurance Bill are likely to go ahead despite the formation of a new government, says an industry body representing medical aid funds.
The Health Funders Association (HFA) held a scenario planning symposium this week where stakeholders looked at possible outcomes for the NHI after the formation of the government of national unity.
President Cyril Ramaphosa signed the NHI Bill on the eve of the elections, sparking uproar from the private healthcare sector and broader business. Critics have slammed the bill as unworkable and unaffordable in its current format. They are unhappy with plans to establish a single fund that will purchase all primary healthcare needs, saying this excludes the private sector.
When Ramaphosa signed the bill into law at a highly publicised event at the Union Buildings on May 15, it was met with a backlash from the medical sector, trade unions and political parties, including the DA, who called it an obvious election ploy.
Now, with the ANC unable to attain a majority and having to rely on other parties to form a government, questions have been raised over whether the NHI legislation could be affected.
The ANC and GOOD have supported the current bill. DA party leader John Steenhuisen vowed to fight it all the way to the Constitutional Court. The IFP has also rejected the bill, referring to it as “a recipe for disaster”.
People won't necessarily abandon their legal challenges, because it gives a court order framework that you can go to parliament with
— Elsabe Klinck, MD at Klinck and Associates
Elsabe Klinck, MD at Klinck and Associates, said while the new arrangement in government could lead to a negotiated settlement, the legal route seemed more effective as there would be a binding ruling from the courts.
“People won't necessarily abandon their legal challenges, because it gives a court order framework that you can go to parliament with,” said Klinck.
At least six organisations are preparing to challenge the bill in court, including trade union Solidarity, the HFA, the South African Medical Association, the Board of Healthcare Funders (BHF), the South African Health Professionals Collaboration and the DA.
Klinck said that while the NHI has been signed into law, it could take years before it is rolled out across the country due to parliament having to approve further legislation needed for the fund, and the pending court challenges.
The legal cases could keep the bill tied up in the courts for at least three years, Klinck said, and she expects that all the cases will be consolidated and lead to one ruling.
“That might delay things in the beginning, because you'll have more sets of advocates that will need to co-ordinate their diaries and so on.”
Insight Actuaries and Consultants joint CEO Christoff Raath said that due to the nature of the government of national unity it had become “very tricky” to determine what would happen with the bill, but it was likely there could be some softening of the NHI framework.
Addressing delegates at the symposium, Raath encouraged medical schemes that normally compete for clients to work together when it comes to NHI. He said despite the competition between them, this was not the time for the private sector to be divided.
Charlotte Mbewu, chair of the HFA NHI steering committee, said the signing of the bill had led to confusion among medical aid members as there was little understanding of what it would mean or when it would be implemented.
Mbewu cautioned that there were no immediate implications for medical schemes and their members and no need for them to panic.
“Quite a lot of medical schemes have been faced with members who want to know whether they should exit. It's our duty to give them the necessary information so they don't make mistakes.”
She said medical schemes were not against the provision of universal health care, but were struggling with the idea of the single-payer system the government is attempting to implement. Mbewu said this model was not feasible as it would put strain on the country's health system.
“What we have found is that around the world there aren't any countries that have implemented similar models in a way that has contributed to the country's betterment of its healthcare system.”
Mbewu said that the HFA would not challenge the entire NHI bill in court, but section 33 of the legislation.
This section states that medical schemes will be allowed to provide “complementary or top-up cover” that doesn’t overlap with the personal healthcare service benefits by NHI.
The HFA stressed the importance of reforms to the bill, saying that in its current state it would have a catastrophic effect on medical schemes. It would lead to a death spiral for the schemes and would erode the health sector in the country.
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.