‘NHI is like building a house with no land on which to put it’
We want a healthcare system able to cover all of us… The process to get there still has to be debated at length…Damian McHugh, Momentum Health
We have sufficient money as a country… we have a private sector that is spending a huge amount of money on a small number of people…Dr Guni Goolab, Government Employees Medical Scheme
Don’t worry about standards… the emphases is on getting the requisite healthcare to the requisite patients.Neil Kirby, Werkmans Attorneys
That’s how Minister of Health Aaron Motsoaledi described the advent of National Health Insurance (NHI) for South Africa earlier this week.
On Thursday, the minister published for public comment two bills that herald the NHI’s introduction.
One of the bills addresses changes to the Medical Schemes Act of 1998, while the other sets out the structure of NHI.
The NHI Bill’s impacts?
It proposes the introduction of NHI, and the compulsory membership thereof for all South Africans.
It proposes the creation of a basket of “health goods” available to all South Africans regardless whether they have medical aid or not.
The items included in such a basket remain unclear for now.
The Medical Schemes Amendment Bill proposes the abolition of co-payments.
The possible range and cost of services available for purchase may be reduced.
Medical schemes may in future exist only as a top-up to what public healthcare services provide.
Consolidation of medical aids is likely.
Kirby says the bills are unrealistic, considering massive capacity and infrastructural deficiencies in the public health sector.
It's a bit like building a house with no land on which to put it, he says.
Whitfield also spoke to Dr Guni Goolab (Government Employees Medical Scheme) and Damian McHugh (Momentum Health).
Listen to the interviews in the audio below (and/or scroll down for more quotes from it).
We started talking about this [NHI] in 1960!Damian McHugh, Momentum Health
It is possible that we do have some unintended consequences…Damian McHugh, Momentum Health
We can have a system where public and private [sectors] work together…Damian McHugh, Momentum Health
There is a role for medical schemes going forward… NHI requires substantial changes to the public and private sector…Dr Guni Goolab, Government Employees Medical Scheme
The issue of co-payments, prescribed minimum benefits… and too many options that are too difficult for members to understand…Dr Guni Goolab, Government Employees Medical Scheme
The minister was careful to describe how we will address deficiencies [in public healthcare].Neil Kirby, Werkmans Attorneys
The potential for a fight is there… you’re attacking an existing system, maybe ‘attacking’ is the wrong word… If I’m paying for NHI and a medical scheme, I might not be inclined to keep the medical scheme…Neil Kirby, Werkmans Attorneys
This shines a light on what is happening in the public sector…Neil Kirby, Werkmans Attorneys
We’re at the outset of this process. There is still much to happen…Neil Kirby, Werkmans Attorneys
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