A low-cost benefit medical aid option should complement the NHI roll-out, CEO of the Health Funders Association (HFA) Phumelele Makatini has said, backing similar proposals by the Council for Medical Schemes.
Makatini said this would expand private healthcare coverage, making it more affordable for more people, and a trimmed list of covered conditions focusing on the most common health concerns – with an emphasis on preventive and primary health care – could meet most families’ needs.
The basket of services currently included in prescribed minimum benefits ensures all medical scheme members have unlimited benefits for emergencies, maternity and chronic conditions, including HIV, asthma, diabetes and many more severe issues, reports The Mercury.
“Greater access to these services reduces the need for hospitalisation, easing pressure on the public health system to build long-term capacity,” she said.
Because the tax base to fund NHI was narrow, there would need to be gradual steps towards addressing practical implications.
“For now, 8.9m people are covered on medical aid, representing some 15% of the population, but a low-cost benefit option could grow this proportion to around 4m people, alleviating the public system’s overwhelming patient numbers and creating the breathing space to improve quality care standards as envisioned under NHI.”
It was time for a shake-up in the structure of healthcare funding models, she said, but added that it was unclear what the tax implications of these more affordable health cover products might be, and whether these funds were set to contribute towards the funding mechanism for NHI.
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