South Africans justified in feeling 'skeptical' about NHI bill

Cabinet approved the National Health Insurance (NHI) bill of 2018 this week, but there is widespread concern about how government will fund it.

In Parliament on Friday, Health Minister Dr Zweli Mkhize said the NHI would address current funding problems in the public health system but didn't expand on where the money would come from.

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Chief executive officer of Proactive Health Solutions, Dr Fundile Nyathi says most South Africans would agree with the concept of national health insurance but are right to be skeptical about how it would work, especially given the lack of detail provided thus far.

What government is proposing is in line with World Health Organisation goals for member states but he points out that, to run the scheme, another state-owned enterprise (SOE) would have to be created.

They are advocating for something called universal health care coverage, meaning all citizens of a country must have a health care system where they can access reasonably good-quality services without having to pay at the point of service.

Dr Fundile Nyathi, CEO - Proactive Health Solutions

How do we make sure there won't be corruption and mismanagement like we're seeing from the other SOEs.

Dr Fundile Nyathi, CEO - Proactive Health Solutions

Dr Nyathi says the NHI pilot schemes rolled out between 2013 and 2018 ended in failure which is why, he believes, former health minister Dr Aaron Motsoaledi was reluctant to report back.

Last year in June, when the previous minister released this NHI bill for comment, he was asked by journalists... and he actually dismissed those pilots. He refused to share any information about what they learned, but we know that those pilots became a failure, in all districts.

Dr Fundile Nyathi, CEO - Proactive Health Solutions

Dr Nyathi feels it's likely that opposition parties will push back the bill for more public participation.

The whole issue of failure to plan, you're blaming for failures. That is the reason why people are skeptical.

Dr Fundile Nyathi, CEO - Proactive Health Solutions

He also outlines the serious challenges facing both the country's public and private health care systems, ranging from staff shortages and poor management in the public system to corruption and collusion in the private one.

There are staff shortages across the board whether it's doctors, or physios or nurses... Posts are frozen because there's no budget to actually appoint new people.

Dr Fundile Nyathi, CEO - Proactive Health Solutions

There are issues around the infrastructure - it is ageing. Some of the hospitals were built more than 50 years ago.

Dr Fundile Nyathi, CEO - Proactive Health Solutions

The medical aid system that drives the private health care system is actually crumbling as well. A lot of medical aids are going bankrupt.

Dr Fundile Nyathi, CEO - Proactive Health Solutions

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