Pre­cious Mat­soso

The Star Early Edition - - WORLD -

un­dergo both vol­un­tary and reg­u­la­tory re­form to be­come aligned and con­sis­tent with the ob­jec­tives of NHI, there will be a need to relook this. How­ever, should this not oc­cur, the med­i­cal schemes will con­flict with the NHI prin­ci­ples and to mit­i­gate the ad­verse im­pact on ac­cess to uni­ver­sal health cov­er­age, their role will be­come lim­ited to that of of­fer­ing only com­ple­men­tary cover.

This is very real risk. The only way in which this can be averted, is for gov­ern­ment to ad­dress is­sues with pub­lic health fa­cil­i­ties - build con­fi­dence in these fa­cil­i­ties and bring them on par with what peo­ple per­ceive as a dif­fer­ence in qual­ity.

Un­der NHI, all fa­cil­i­ties must de­liver a de­fined min­i­mum stan­dard of care, and this places pres­sure on the gov­ern­ment to en­sure that pub­lic fa­cil­i­ties are NHI com­pli­ant and ready.

How will you man­age de­mand? Cur­rently the med­i­cal aid can de­cline a re­quest for a ser­vice be­cause funds have been ex­hausted.

The med­i­cal schemes will be more tightly reg­u­lated. We will amend the med­i­cal schemes

Act to pre­vent this from tak­ing place. The Pre­scribed Min­i­mum Ben­e­fits (PMBs) will be re­placed with a

For NHI to achieve uni­ver­sal health cov­er­age re­quires a clear and firm com­mit­ment to part­ner­ship with the pri­vate sec­tor. Po­lit­i­cally and through stake­hold­ers, in­clud­ing civil so­ci­ety, this must be ap­pre­ci­ated and rec­og­nized.

The sec­ond big­gest fear, is hav­ing pub­lic health fa­cil­i­ties that do not meet min­i­mum stan­dards.

This re­quires a trans­for­ma­tion within the pub­lic sec­tor. If we don’t im­ple­ment in­no­va­tive ways of chang­ing the way care is de­liv­ered, NHI could fail.

We need to rad­i­cally trans­form our ap­proach to ad­min­is­ter­ing and man­ag­ing pub­lic health fa­cil­i­ties. We need to find lower cost ap­proaches to de­liv­er­ing care both within the pub­lic and pri­vate sec­tor.

The lack of un­der­stand­ing of what we are try­ing to do is the big­gest chal­lenge. Within this, is the need to un­der­stand that this is a process of trans­for­ma­tion and this re­quires that we some­time need to take dif­fer­ent paths to achieve the same goal.

There must be a re­al­is­tic and prag­matic ap­proach that builds con­fi­dence and does not de­stroy what we have. This does not mean we

The im­ple­men­ta­tion of NHI must fo­cus on those in great­est need, the most vul­ner­a­ble groups of our pop­u­la­tion, those that do not have or can­not af­ford cover.

We can­not start with those that al­ready have cover. How­ever, this does not mean we ig­nore the is­sues af­fect­ing the groups with cover. But we need to pri­ori­tise those in the most vul­ner­a­ble group­ings. For in­stance, one of the big­gest con­cerns of peo­ple who have med­i­cal cover is that their funds get ex­hausted as early as June and they re­main with­out cover for the rest of the year.

Through NHI-in­spired ini­tia­tives such as price reg­u­la­tion of med­i­cal ser­vice and the re­duc­tions of the cover op­tions, we will en­sure that those with med­i­cal aid cover are in­deed cov­ered through­out the year. This is the big­gest prob­lem fac­ing those who have med­i­cal aid cover at the mo­ment.

On the other end of the spec­trum, there are the un­em­ployed who do not have any form of med­i­cal cover.

We will pri­ori­tise this sec­tion of the pop­u­la­tion by ex­tend­ing cover to them. The plan is to en­sure that all South Africans are cov­ered.

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