The National Health Insurance scheme is meant to provide affordable and quality healthcare to all citizens, regardless of one’s socio-economic standing.
This is what Health Minister Dr Aaron Motsoaledi told the media at a briefing at Media Park in Johannesburg today.
The scheme will run hand-in-hand with the United Nations resolutions, which has committed South Africa and the rest of the world to achieve Universal Health Coverage (UHC) for citizens globally, without financially burdening them.
Amongst the main topics of discussion was the monopoly that the private healthcare sector currently holds in the country, servicing the needs of only 16% of the country’s population, whilst the remaining 84% of citizens are left to the services provided by public hospitals. Yet private healthcare is where one is expected to get a higher level of treatment, Motsoaledi said.
“The concept of medical aids presumes that health is a condition of employment, but healthcare is a right for all citizens. The problem with private healthcare is the exorbitant costs which a majority of the population cannot afford,” he said.
According to recommendations by the World Health Organisation, each country should allocate at least 5% to their GDP on the healthcare system, with South Africa currently spending 8.5% of its GDP on health.
“European countries allocate 9% of their GDP to healthcare, but their healthcare system differs, even though the expenditure falls within the same band as South Africa,” he explained.
Motsoaledi further compared the expenditure with fellow Brics nations India and China, who allocated 4.6% and 4.2% of their GDP respectively, yet “these countries have better outcomes” and “their systems are better”.
The NHI has prioritiseed the following five aspects of healthcare to be integrated into the scheme:
• Maternal and Women’s health
• Mental illness
• The elderly
• The disabled
“The treatment for breast cancer currently costs women R24 000 a treatment. And the prescribed number of treatments is 17. It doesn’t matter how rich you are, it leaves a woman even more vulnerable because how many people can actually afford this?” Motsoaledi asked.
“We want to change this and can’t say how far along we are with negotiations but we are working on this,” he said.
In June this year, the Competition Commission announced an in-depth investigation into three pharmaceutical companies for allegedly price-fixing cancer drugs.
A part of the UHC includes “health financing reforms”, which ties in with the NHI, in that it seeks to pool funding from taxpayers in order to ensure that the NHI always has funds available.
“Tax rebates and tax credit, which middle-class earners get, shouldn’t be there. In 2015 the government gave back R20 billion in tax rebates,” he said.
The NHI has, however, received backlash in the past for its refinancing policies, with some saying that they shouldn’t have to compromise their healthcare if they are paying for it.
“What the NHI means is that those who are on medical aid, and those who are not and utilise public hospitals and clinics, will all eventually get the same level of treatment and care. The standard of treatment will not drop, but rather increase,” he said.
For now it is still unclear when the NHI scheme will come into effect, but the first steps include creating a fund.
“It is a transitional fund, the moment Treasury gives the go-ahead then we can start,” he said.