NHI to be passed in 2012
The proposal for a National Health Insurance (NHI) scheme in South Africa has been under debate for the last few years.
However, following the announcement by Government spokesman, Jimmy Manyi that government is expected to approve the NHI policy document at its next Cabinet meeting in August, and the subsequent allocation of a portion of the national budget towards NHI in February, the question is now "when, as opposed to if NHI happens".
After the document is presented to the Cabinet in August, a White Paper will be made available for public comment. The government white paper on healthcare reform is expected in September and needs to fill the gaps with much-needed specifics on the planned National Health Insurance Scheme (NHIS) implementation.
The first implementation phase of the NHIS is supposedly set to begin in 2012, and it will make scheme membership compulsory for all South Africans. It will be phased in over a 14-year period.
The funding for the NHIS is still under consideration some of the options include a payroll tax (payable by employers), an increase in the VAT rate and a surcharge on individuals’ taxable income.
It is potentially the most expensive policy change advocated by the African National Congress since it came to power.
Health Minister Aaron Motsoaledi has made it clear that he is intent on regulating private sector prices to contain costs and provide certainty to funders — including medical schemes and the state.
He is also committed to re-engineering the country's primary healthcare system. He announced a plan to introduce three streams of care which will have a particular impact in rural areas and pave the way for the NHI
- The first is the provision of specialists in each of the rural district municipalities. These positions will be announced by the end of July, and if the posts are not filled, the minister has received an undertaking from all the medical schools in the country to fill the posts from among their own staff on a year-long rotational basis.
- The second is the establishment of a school health programme. "We have 12 million learners and no one taking care of their eyesight and hearing. Drugs and teen pregnancies are running rampant, while we wait for them at the hospital. I want to see nurses in every school, and we will call on the help of retired nurses if necessary.
- The third is the provision of primary healthcare workers in every municipality. The success of a pilot project in KwaZulu-Natal has led to plans to roll the system out to every municipality in the country.
Business, consumers and health practitioners are still in the dark on the proposal but are hoping for more details on service delivery models and financing. The proposal is expected to reform the way state health services are provided for and financed. The private sector will be looking for signals about its future role, while consumers and employers are anxious to know if they will pay more taxes.
Even thoughthe details are yet to be made public regarding the NHI, there are no uncertainty that it will be implemented as the government are under increasing political pressure from its allies in the tripartite alliance to deliver on its promise to introduce the NHI to provide universal access to quality healthcare.