Share

All South Africans should participate in public hearings on NHI

accreditation
Once in place, the NHI system will be the most far-reaching act of social transformation SA has witnessed since 1994. Picture: Muntu Vilakazi
Once in place, the NHI system will be the most far-reaching act of social transformation SA has witnessed since 1994. Picture: Muntu Vilakazi

Public hearings on the National Health Insurance Bill are here. Let’s all participate, write Busani Ngcaweni and Nondumiso Khumalo

Every parent in this country has had their fair share of tending to a sick child.

But the worst nightmare is when a parent realises that a very sick child is not responding to basic treatment.

The comfort of knowing your sick child can be rushed to a nearby hospital or clinic for professional medical treatment is, unfortunately, not enjoyed by all citizens.

Although some know they will receive immediate professional and high-standard care, others know they will have to wait in endless queues, to either receive substandard treatment or, worse still, be turned away after patiently waiting for hours in the queue.

The untenable reality that access to decent and quality healthcare services is determined by one’s ability to pay for them is one of the greatest travesties of our time.

Access to healthcare, regardless of one’s socioeconomic circumstances, is a fundamental right enshrined in the Constitution.

A people-centred health system is one of the core pillars of the National Development Plan.

The Reconstruction and Development Programme expounded the importance of community participation in government policy, planning, managing, delivery, monitoring and evaluation of health services.

Read: A well-functioning public health system is everyone’s business

An inclusive approach is not only aligned to our constitutional democracy but it is also an integral part of good governance, because of its potential to ensure government accountability and responsiveness.

The National Health Insurance (NHI) “war room” in the presidency – an intergovernmental coordinating mechanism – has noted the recent call by Parliament’s portfolio committee on health to the public to make submissions through the participatory public hearings process.

Parliament has, since 1994, passed a significant number of effective and far-reaching laws that have advanced the course of social transformation in the country.

Recently, a panel led by a former president, Kgalema Motlanthe, surveyed the laws passed by Parliament and concluded that the majority were indeed transformative and served to undo the legacy of colonialism and apartheid.

Parliament is now facilitating dialogue across different socioeconomic classes and diverse interest groups to usher in one of the most revolutionary instruments to advance social equity yet – the NHI.

Communities will be given the chance to influence the direction of the NHI in a meaningful way.

This is important because it affects their lives. Public engagements on issues related to universal health coverage are not new.

Over the years several reforms were tried with varying rates of success.

Read: The success of NHI depends on planning

Arguably, apart from the Constitution and the national minimum wage legislation, the NHI is the most far-reaching act of social transformation this country has witnessed since 1994.

For the first time in our history, all citizens will have access to quality healthcare regardless of their socioeconomic background.

The health-financing system will be implemented through the creation of a single fund that is financed and administered by the public.

Through the pooled funds, the state can actively buy services to enable all citizens to access quality and affordable health services.

This will alter current reimbursement models in the private sector, including budgeting within the public sector, with the expectation being value-based delivery and reimbursement.

Based on the need to address structural imbalances in the health system and to reduce the burden of disease for all – and not just for the privileged few – the NHI will provide free services at the point of care and offer a mechanism for improving cross-subsidisation in the entire health system.

Since it is rooted in the principle of social solidarity, the NHI will provide financial risk pooling to enable cross-subsidisation between the young and old, rich and poor, as well as the healthy and the sick.

The presentation of the NHI Bill to Parliament represents a significant step in addressing fragmented financing and service delivery in the national health system since 1994.

The NHI is not just about improving equity in access to healthcare but it is also about ensuring that our parents, grandparents and children receive proper treatment in well-run facilities operated by professionals regardless of where people live and how much or how little they have.

The NHI enforces the constitutional principle of healthcare as a public good – and that it should not be treated like any other commodity of trade but as a social investment.

It is premised on affordability, as health services will be procured at reasonable costs that recognise the need for sustainability within the context of the country’s limited resources.

It places a premium on quality of care and efficiency.

It is about ensuring that the R493 billion – being spent annually on healthcare in both the public and private sectors – results in better levels of healthcare and standardised services for all citizens.

A strict referral system from primary healthcare will be implemented to significantly alter health-seeking behaviour for most of the population, especially those who are used to accessing higher levels of healthcare for basic ailments.

A people-centred health system is one of the core pillars of the National Development Plan. The Reconstruction and Development Programme expounded the importance of community participation in government policy, planning, managing, delivery, monitoring and evaluation of health services.

Under the NHI, available resources will be allocated and used efficiently to promote health interventions that must result in improved health outcomes.

It will ensure that the health system meets acceptable standards of quality and achieves positive health outcomes and that innovative service-delivery models are tailored to the needs of the local population.

Although the NHI Bill has the ambivalent support and fierce contestation from groups with vested financial and ideological interests, we believe that popular participation by the public will settle the matter and help the country move forward.

Parliament will mediate key areas of contestation, such as changes in the role of provinces when the national department of health delegates functions to manage the provision of healthcare services, changes to the role of medical schemes and the mooted reallocation of funding for medical scheme tax credits.

On the contrary, universal health coverage is neither a fight of the poor against the rich nor an encroachment on the profits of the private sector.

We cannot build a prosperous and economically thriving nation if a small minority of our workforce is healthy while the majority is vulnerable to ill-health and disease.

All South Africans are encouraged to join Parliament and be part of the public participation process.

The fundamental right to an equal standard of healthcare is good for social cohesion and nation-building, and a healthier population will inevitably contribute to economic growth and socioeconomic stability in South Africa.

Ngcaweni is head of the policy unit in the presidency and Khumalo is on secondment as a health economist in the NHI war room

TALK TO US

Are you going to take part in the public discourse about the NHI and how it will affect you?

SMS us on 35697 using thekeyword HEALTH and tell us what you think. Please include your name and province. SMSes cost R1.50. By participating, you agree to receive occasional marketing material



We live in a world where facts and fiction get blurred
Who we choose to trust can have a profound impact on our lives. Join thousands of devoted South Africans who look to News24 to bring them news they can trust every day. As we celebrate 25 years, become a News24 subscriber as we strive to keep you informed, inspired and empowered.
Join News24 today
heading
description
username
Show Comments ()
Voting Booth
Do you believe that the various planned marches against load shedding will prompt government to bring solutions and resolve the power crisis?
Please select an option Oops! Something went wrong, please try again later.
Results
Yes
21% - 103 votes
No
79% - 390 votes
Vote