There was unanimous agreement from several concerned healthcare groups and medical schemes in Cape Town last week that the National Health Insurance (NHI) Bill, in its current form, needs urgent amendments before being passed – and that the risk of a lengthy legal battle “cannot be under-estimated”.
The Cape Town leg of the public hearings into the Bill – which closed on Tuesday – were held in the legislature, with Gary Feldman, representing the Financial Intermediary Association of SA, being first to highlight his concerns, saying the Bill should not be centralised.
“While we support the goal of expanded universal healthcare… it should be ward-based primary healthcare, so each region and province can determine what is needed and how to allocate resources at ground level,” he said.
He warned there were many barriers to UHC, and that the funding and resourcing of the NHI were a major concern, a challenge “raised by the national Minister of Finance and which concerns us as an organisation”, reports News24.
“To roll out universal healthcare, we require a collective effort with sound policy decisions, and not just one size fits all,” he said.
In its current form, the Bill might be subject to several court challenges, and the risk of a lengthy court battle cannot be underestimated, Feldman added.
Momentum Metropolitan Health Solutions’ Dr Boshoff Steenekamp said the Bill’s introduction would see a 28% reduction of the provincial Health budgets.
“That will weaken the provincial legislatures as well as the provincial Health Departments; healthcare purchasing decisions will no longer be taken at a provincial level but will be made by the NHI fund,” he warned, adding that the slash in funding for the provincial public sector could destroy it.
“This will be another blow on top of the current budget cuts.
“Pilots must be done before these funds are withdrawn from the provincial budget allocation.”
Business Unity South Africa board member Stavros Nicolaou said that while supportive of the NHI Bill, members believed a single fund approach was unworkable and would exacerbate, rather than reduce, health inequality.
“The country is at its best when the private and public sector work together.”
Likewise, the Board of Healthcare Funders said it supported the concept of universal health coverage but not the NHI Bill in its current form.
Mediclinic’s Clara Findley said there were “serious concerns with the Bill and we would like to address those … we believe there are mechanisms to fix it”.
Damaris Kiewiets, chairperson of the Cape Metropolitan Health Forum, told the legislature that the current dysfunctionality of the health system must be fixed first, and that healthcare was not a privilege but a constitutional obligation.
The Western Cape Government has been vocal about its stance on the NHI Bill, with MEC Nomafrench Mbombo saying in July that the country needs UHC – “which means free healthcare for everyone, but NHI is a money bill; it doesn’t say anything about UHC”.
News24 article – Concerns raised at public hearings over NHI Bill in Cape Town (Restricted access)
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