Corruption, accountability and too much power to the minister, with little parliamentary oversight, are some of the major concerns about the National Health Insurance (NHI) Bill, with Solidarity Doctors’ Network board member Dr Angelique Coetzee saying the perception that people will have the same high quality of healthcare as offered by the private sector could be an illusion.
She said it was important to note that the current NHI Bill was actually a funding model, with scant details and no clear guidelines of what was to be funded, reports The Citizen.
“So we are all fighting about a funding model, but at the end of the day, there are not clear guidelines how this will be done,” she added.
In the blueprint, South Africans will no longer be required to contribute directly to a medical health scheme to get quality healthcare, with the NHI funded from general taxes, contributions of people earning above a set amount, and contributions from employees to the fund.
But Coetzee said she did not see this happening.
“I believe there’s a perception people will maybe get more or less the same services they get in the private sector as if they were on medical scheme, but I do not think that is going to happen. So all of that is a huge concern to us and we need clarity,” she said.
She highlighted other red flags in the Bill: very little parliamentary oversight, lack of transparency on how exactly the NHI will work and the enormous power given to the minister of health.
“The minister will have the power to appoint people to the different committees, oversight committees, and that’s a problem as well. We have seen how it went all wrong with [cadre deployment] corruption,” she added.
While in full support of NHI, civil society organisation Active Citizens Network, also pointed out some concerns, including constitutional and governance issues, the role of medical schemes as well as financing.
The organisation’s Dr Bonginkosi Shozi said the Bill establishes the NHI fund as “an autonomous public entity, as contained in Schedule 3A to the Public Finance Management Act”, however, its governing board is “accountable” to the minister.
Shozi said that the board, its CEO, and its chairperson are all appointed by the minister, with little direction or oversight, amounting to micro-management by the minister and undermining the independence of the fund.
Shozi said the NHI was too critical an initiative to risk failure and Parliament has a duty to ensure the legislation on which it is founded will stand constitutional scrutiny.
The Citizen article – NHI: Giving minister too much power among Bill’s flaws (Restricted access)
See more from MedicalBrief archives:
NHI plans still on track despite court ruling, says Minister
Solidarity takes legal steps over NHI ads for jobs that don’t yet ‘exist’
Medical schemes’ NHI transition will take ‘years to decades’ – Crisp
NHI will ‘require time and excellent leadership’ – Discovery CEO Adrian Gore