The government of national unity (GNU) has apparently quietly reached an “agreement” on two key aspects relating to National Health Insurance (NHI) which, if confirmed, spells good news for medical aids.
Planning, Monitoring & Evaluation Minister Maropene Ramokgopa told News24 that the ANC and the DA have struck an informal agreement to drop sections of the law that could collapse medical aids.
Neither party had confirmed the news at the time of publication.
Ramokgopa said she had a meeting with Health Minister Aaron Motsoaledi and DA leader John Steenhuisen on the sidelines of last week’s Cabinet lekgotla in Pretoria, and that they had all agreed to a proposal that would not completely demolish medical aid schemes and that a ministerial advisory council will be established, which will also iron out funding issues.
This council will sit when the Medium-Term Development Plan (MTDP) has been adopted as policy, she said.
She said the advisory council would be tasked with determining how NHI funding would work, and if patients “want to participate in public or private healthcare, they would do so through the fund”.
“…It will be in that ministerial advisory council where there will be talk on how the fund will work and (whether) there will still be subsidies and those kinds of things. That was the big issue,” she said.
“Everyone agreed for the MTDP to continue on the understanding that the council at the lekgotla will … continue with the implementation.”
She said President Cyril Ramaphosa will spearhead this process.
At the time of writing, Steenhuisen had not responded to a request for comment. However, Ramokgopa insisted he was happy about the agreement.
The apparent agreement came just days before Ramaphosa’s SONA today, which will be based mostly on the delayed Department of Planning, Monitoring and Evaluation-led MTDP.
Ramokgopa, whose office is charged with supporting the implementation of the National Development Plan (NDP) through the five-year MTDP, said the delay in initiating the plan was caused by, among other things, the GNU’s internal contestation over the NHI.
When News24 expressly asked whether the NHI impasse had now been resolved. Ramokgopa insisted it had.
She said: “There was an agreement on the Act on its own. But the disagreement was where the distribution of the health budget would be done because then it meant private (sector) participation was cut out.
“Now, what we will iron out is only the private participation …to which we agree that in the ministerial adviser’s council, we will have the private sector, ourselves, and all the other role-players in the system, to discuss how to implement the NHI.
“The NHI is agreed upon, but the implementation – just that part of private sector participation – is what will be ironed out. But we agreed we can’t cut the private sector out; we have to find a way of collaborating with them.”
Calls to Motsoaledi went unanswered. A request for comment was also sent to him via WhatsApp.
About funding, Ramokgopa further said: “You’ll be surprised that government is already subsidising medical aid. So, the disagreement was more on that money being based only for government hospitals, and not subsidising medical aid anymore.
“The issue is not bringing the private sector to play a role in having funding. It was more on how do we divide the funding that we have from outside and from the fiscus in such a way that the private sector can do what they need to do, (and for) the government to play a more meaningful role.
“In terms of the money, of course, capital-raising will still be done from outside because there are many funders out there wanting to fund public health, precisely because of some of the agreements and discussions taking place in the UN in terms of making sure that the SDGs (Sustainable Development Goals) are going to be achieved.
“Part of the agreements from the UN level is that developing countries, like South Africa, have to be funded in some of the things they’re doing.”
However, earlier in the week, Gauteng ANC chairperson Panyaza Lesufi vowed that no one and nothing would deter South Africa from implementing NHI, saying that the NHI, along with the controversial Basic Education Laws Amendment (Bela) Act, are non-negotiable despite vehement resistance from opposition parties.
Speaking at the ANC’s 113th Statement Celebration in Johannesburg on the weekend, Lesufi insisted no external force would dictate the ANC’s agenda, especially on critical policies aimed at transforming society, reports News24.
He again called for the immediate implementation of the NHI Act, dismissing the idea that access to quality healthcare should be a privilege reserved for those who could afford private medical aid.
“No one should be rejected in a private hospital because they do not have a medical aid,” he said, urging both President Cyril Ramaphosa and Minister of Health Dr Aaron Motsoaledi to move forward with the NHI roll-out “without delay”.
He added Gauteng was prepared to allocate resources towards the success of the NHI, pledging that the province would budget for its implementation and open more hospitals and clinics to improve healthcare services.
Lesufi dismissed opposition from the DA, singling out DA federal chairperson Helen Zille, who has been vocal against the policy.
“We will not listen to a Zille or the DA that NHI must not be implemented.”
The DA is against the NHI in its current format, with leader John Steenhuisen saying that “if you include NHI and you abolish medical aid and have it transferred to a fund, there is no way we would be able to support a budget like that because it’s not a real budget”.
“The billions of rands that NHI is expected to cost will blow out the budget massively. So, in the medium-term development plan… we should …focus on fixing primary healthcare and public healthcare facilities.”
News24 – 'We will not listen to a Zille or the DA': Panyaza Lesufi …
See more from MedicalBrief archives:
Will Cabinet lekgotla pave way for NHI compromise?
Government open to more talks and ‘collaboration’ on NHI