WE DON’T HAVE TO REINVENT THE WHEEL WITH NHI

AFRICAN Unity Life welcomes President Cyril Ramaphosa’s confirmation in his State of the Nation Address that the National Health Insurance (NHI) Bill is almost ready for submission to Parliament.

Considering we’re heading to the polls on May 8, it is clear that there won’t be time for this Parliament to deal with it and hence work will probably only be looked at after June or July, once the new Parliament has been convened.

In relation to giving the consumer a better deal, we understand that a primary aim of the bill will be to regulate medical schemes in such a way that co-payments for health care will be eliminated and that a uniform tariff structure for healthcare providers will be implemented. This sounds positive, but it might have further unintended repercussions. For example, co-payments charged for certain procedures are in place to protect the funds available for claims that are truly a medical necessity

– it is a risk management tool. In such circumstances, co-payments should encourage members to consider alternatives to these elective procedures. If co-payments on elective procedures are scrapped, this could open up risk for the majority of members in favour of the few.

With regards to the smaller medical schemes and how the legislation will affect them, there have been suggestions that the smaller schemes should be disbanded to incorporate these members in the bigger schemes.

This is, however, something that should be addressed in legislation, because the Medical Schemes Act allows a scheme to be registered if they have 6 000 or more members. Amalgamation of these smaller schemes is also a possibility.

The NHI proposals of course envisage a single system, with an option for the wealthy to buy additional cover. Taking into account the payroll tax that is likely to be introduced to fund NHI will make people seriously consider whether the additional cost of medical scheme membership is worth it.

This can have a devastating influence on smaller schemes as they will play a role in filling the gap.

Another aspect of NHI, more specifically, envisages a publicprivate partnership (PPP) and I believe the private sector would have to come to the party to help with the development and successful implementation of NHI.

With the Medical Schemes Amendment Bill in the final stages and NHI on the go, we need the best skills from the private sector to contribute to the public sector, so as to achieve a better life for all South Africans.

We don’t have to reinvent the wheel with NHI; we have to make use of the lessons learnt in the private sector.

This can set the stage for a PPP that can work. The private sector has the knowledge that can shape NHI to the benefit of the public sector.

Johan Ferreira is the chief legal and compliance officer at African Unity Life.