How the NHI will affect citizens
THE implementation of the National Health Insurance (NHI) means that Koko from Ga-Mphahlele and Thabo from Diepsloot will be able to go to their nearest clinic or doctor when they fall ill.
The two citizens have different realities when it comes to access to health-care services.
Koko lives in a rural area, and rural areas have a shortage of health-care providers in the public sector.
When the NHI is implemented, Koko can visit the private GP in the village, without worrying about payment. The GP will refer Koko to the next level of care if Koko needs it.
Access to health-care services will be improved and patients will be able to benefit from health-care providers who are more concentrated in the private sector.
Thabo lives in Diepsloot where he is closer to a private hospital than a public hospital, but he is not able to access the private hospital as he does not belong to a medical aid scheme.
When the NHI is implemented, Thabo will be able to be referred to his closest hospital, including a private hospital.
The laws around health care make it difficult for the government to buy beds from private hospitals, even though private hospitals have many unused beds.
The implementation of the NHI does not mean all citizens will have to use the limited resources in the public sector. The NHI means that the government will buy services from available health-care providers on behalf of all people so that they are able to access health care when the need arises.
The existence of a private sector that uses 50% of the country’s expenditure for health for 16% of the population means that the private sector will always pull health-care providers to it through more lucrative packages. Society invests in the education of health-care providers to improve service delivery to all people who need health care.
People who contribute to medical aid schemes will no longer contribute towards them, unless they choose to buy benefits that are not covered by the NHI.
The implementation of the universal health coverage starts with whatever the country can afford.
The government subsidises the private sector through tax rebates for people belonging to medical aid schemes and the government, as an employer contributing to GEMS (Government Employees Medical Scheme) for its employees’ medical aid schemes. This is money that can be used to buy services for everyone.
The World Health Organization has advised that every country must use its resources to embark on the journey to universal health coverage.
Through strategic purchasing and minimising inefficiencies and corruption, the budget for health can buy more services for everyone and improve health outcomes.