Health Minister Aaron Motsoaledi will undertake a “massive roadshow” on the National Health Insurance in efforts, he says, to meet all stakeholders and understand their concerns, and find out what kind of universal health coverage people would find acceptable.
But at the same time, implementing will begin of Section 57 of the NHI Act, which deals with transitional mechanisms the NHI will require, reports News24.
“We are going to implement Section 57 but simultaneously we are intending to run massive roadshows and workshops to meet all the relevant stakeholders and hear their concerns. (Despite) the war raging about NHI, you will never hear anyone say they are against universal health coverage (UHC). They all say they accept UHC, but then there is a big but, and they will say they don’t support it in the form (of the NHI Act). So, our job is to find out in what form they want it. What is it that if it were on the table, they will go for it?”
The concession follows an undertaking by President Cyril Ramaphosa to his government of national unity (GNU) partners to review the areas of disagreement on the NHI, to find consensus.
Most stakeholders who have objected to the NHI Act – like the DA and Business Unity South Africa (Busa) – have expressed their commitment to UHC.
Motsoaledi said he would also be visiting communities and others who stood to benefit most from the NHI, to explain the impact of the court judgment last month in which sections of the National Health Act were struck down for unconstitutionality.
The sections dealt with the requirement that medical practitioners obtain a certificate of need from the Department of Health to establish a facility or run a practice. This had confused people, the Minister said.
Asked if the extensive previous consultation process indicated that the public had not been sufficiently convinced of the NHI, Motsoaledi said there was no evidence that the masses of people who would be the real beneficiaries had not bought into it, and that thus far, only the beneficiaries of the medical aid system have voiced objections.
Section 57 deals with establishing institutional arrangements, like the appointment of a ministerial advisory committee, he added.
Now that the NHI Act is law, 11 other pieces of legislation – the Health Professionals Act, the Medical Schemes Act, the Dental Technicians Act, and the Traditional Health Practitioners Act – also needed to be amended.
He said NHI could take 15 years to implement.
But it would also take R1.3trn per year, according to Momentum Health Solutions, and the DA, among others, has questioned the source of this funding, and how it will be protected from corruption.
In a statement on PoliticsWeb, Michele Clarke, DA spokesperson on Health, wrote that the party had noted the warning of how much money was needed to provide each South African with the same quality of care as received under the private health system.
“The DA has always been in support of universal healthcare, especially for the poorest of the poor, however, NHI in its current form won’t solve this and can collapse the healthcare sector.
“We once again ask President Cyril Ramaphosa and National Treasury to explain how the NHI will be funded. We also require detailed information on how the NHI Fund will be safeguarded against the institutionalised looting and corruption rife within the public health sector.
“We believe that universal access to quality healthcare can only be provided when the root causes of decline are addressed – corruption, maladministration, dangerous infrastructure, broken equipment, medical stockouts, and insufficient personnel.”
She wrote that the DA had “never wavered in our efforts to improve public health care by holding the executive to account”.
“We have done multiple oversights in the provinces, requested investigations from the Human Rights Commission, the Special Investigating Unit, and the Public Protector, and pushed for intervention and consequence management. Instead of addressing the systemic failures that erode the public health system, the department opted for a centralisation of power and funds, that will make looting much easier while also crushing an overburdened public health system.
“All of the pleas of the DA, health experts, medical professionals, and civil society have fallen on deaf ears.”
She said the party would continue to question and rally against the NHI.
Meanwhile, Discovery Health Medical Scheme is “participating in the preparation of potential litigation” against the NHI scheme with the Health Funders Association (HFA), it says.
Principal Officer Charlotte Mbewu told BusinessTech that Discovery was “closely monitoring the NHI” and its impact on its members.
“We remain concerned that, in its present form, the NHI Act is unworkable without private sector collaboration and involvement and will not lead to the desired improvements in healthcare for all South Africans,” she said.
Mbewu said Discovery has proposed using a multiple-funder model for healthcare in South Africa to reduce risk and enable a sustainable healthcare environment in the long term.
The HFA is one of many groups and healthcare representative bodies pursuing litigation against the NHI, others including Solidarity, the South African Medical Association (SAMA), the Board of Healthcare Funders (BHF), the South African Health Professionals Collaboration and the DA.
The legal challenges against the NHI are happening on several fronts, including technical implementation as well as the rationality applied in processing and approving the laws.
Experts have said that because the NHI Act is now law, only three mechanisms exist that can affect its implementation.
1. An agreement on a phased approach and only promulgating certain clauses in the Act at differentiated times are subject to consultation between the President, Minister of Finance, and Minister of Health, primarily on budget, resources, and capacity.
2. The executive or parliament introduces an amendment to the NHI Act.
3. Multiple litigious actions result in an outcome, forcing the Department to review and amend the Act to address the concerns in a court ruling, and thus, the Act cannot be implemented in its current state.
BusinessTech – Discovery preparing legal challenge to the NHI
See more from MedicalBrief archives:
Pinning down the real cost of the NHI: SA tax expert
Government dodges issue of NHI funding model – DA
Private healthcare corruption costs billions, says Motsoaledi