Health Minister Zweli Mkhize met with government officials, health practitioners and other guests in Pietermaritzburg on Friday to clarify issues related to the roll out of the National Health Insurance (NHI). According to a Sunday Tribune report, Mkhize said the Bill, which was recently tabled in Parliament, faced several challenges, but under the NHI, quality, equitable healthcare would be available to all South Africans, foreign nationals and asylum seekers. He said it would be an individual’s condition, and not the person’s pocket, which would determine where treatment was received.
“The idea is to create a fund that will have contributions from right across sectors. The current allocation that the government is putting into health will obviously go in. To pull the funds up, general taxes and specific contributions which could be surcharges from various other areas like tobacco and cigarettes could be added, but that will be a determination the Treasury makes at the right time,” he said.
The minister said once the fund was established, an oversight body to ensure transparency would be formed and would allow complaints and concerns to be raised with it. Mkhize said that several committees consisting of specialists from various disciplines would be formed to ensure the smooth running of the system.
Mkhize said the private sector, which serviced 26% of the population, utilised 66% of the specialists and the NHI sought to have their services shared by the entire population. “We are looking at how private general practitioners will be brought to be part of the primary healthcare network.”
He said they were already at advanced discussions with the private practitioner medical associations. KZN Health MEC Nomagugu Simelane-Zulu said the meeting was the first of its kind and that more engagements would be held across the province.
Mkhize also said the government had assurances that the NHI Bill was constitutional and vowed to disprove fears that it would lead to corruption and cripple the country financially. According to The Witness, he said government would handle the implementation of the NHI cautiously and had no intention of bankrupting the country. He gave an assurance that the national health service would be based on successful models in countries like Japan and Norway.
“When the fund structure is set up, there is going to be a body that will conduct oversight. In the first instance, the body will allow the public to be able to raise complaints and concerns so that they can be investigated. The level of transparency is going to be very strong. Secondly, the oversight will ensure that the budget is used for what it’s supposed to do and not other things on the side.”
Mkhize said they will set up an anti-corruption team that will include civil society and investigating agencies to fight NHI corruption.
Popo Maja, head of communication and a departmental spokesperson in the National Health Department attempts in a Daily Maverick report to offer more clarity on the plan and timelines by posing some of the questions being asked and offering answers.
Maja writes: “It will not be easy for members of the public to visualise National Health Insurance (NHI) until it is being implemented. There is increasing inequity around the world, with the richest 1% of the population now owning half of the world’s wealth. Life expectancy in the poorest countries of the world is appreciably lower than in the wealthiest and living in areas blighted by poverty can mean a shorter lifespan and a lost future. The disparity is observed between countries and between different communities within countries, with the most vulnerable, marginalised and stigmatised being left behind.
“Certain things must be said and said very categorically. Do you believe health is a human right and that all human beings should be able to fulfil their potential in dignity and equality in a healthy environment? Do you believe women should not die while giving birth? Do you believe children should not die from preventable deaths? Do you believe people should not be pushed into poverty for accessing health services? Do you believe in a world where everyone can live, healthy, productive lives regardless of who they are and where they live? If you say “Yes” to these questions, then you believe in universal health coverage (UHC).
“Implementing UHC that is truly universal means making progress towards equity, inclusion and social justice. It means a people-centred, human rights-based approach and community-led service delivery, as well as a recognition of the need to address the social determinants of health, including necessary reforms of laws and policies and removing stigma and discrimination and gender inequity.
“World leaders agreed on 23 September 2019 that every person – no matter who they are, where they live or how much money they have – should be able to access quality health services without suffering financial hardship.
“Health is a human right for everyone, at every age. At present, not only does a fundamental human right remain unfulfilled, but it is also increasingly evident that the capacity to detect and respond to disease outbreaks depends on a healthcare system that reaches everyone.
“Before it can become a law, the NHI Bill must be passed by Parliament. In the next five years, the government’s efforts will be concentrated on preparing the NHI infrastructure that will administer the fund and provide services.
“At the same time, government will give priority attention to refurbishing clinics and hospitals, train and employ more staff, improve the quality of health care, implement systems to ensure medicines do not run out of stock in our facilities, and ensure that maladministration and corruption is uprooted so that all facilities will be ready for NHI.Sunday Tribune report (subscription necessary) The Witness report (subscription needed) Daily Maverick report