Yesterday was the last day for the public to submit written comments on the controversial National Health Insurance Bill (NHI) after Parliament extended the deadline last month.
The bill, which is now before the National Council of Provinces (NCOP), was passed by the National Assembly in June and is now on its final step before President Cyril Ramaphosa signs it into law. The call for submissions was made in the beginning of August with a deadline of September 1. However, this was later extended to September 15.
Making its submission on the last day to the NCOP’s Select Committee on Health and Social Services, the Institute of Race Relations (IRR) said there were serious problems with the bill itself and the public participation process was improper. In addition, no Socio-Economic Impact Assessment System (Seias) study has been done on the bill.
Mlondi Mdluli, IRR campaign manager, said the implementation of the NHI Bill would result in the nationalisation of South Africa’s excellent private health-care system, meaning that the country’s 75 remaining medical schemes will be pushed out of operation.
He said this would also lead to greater enforcement of failed BEE procurement rules, to which every contract for health goods and services will be subject.
“Second, the demand for ‘free’ NHI services will be so enormous that all participating clinics, GPs, and other primary providers will inevitably have very long lists (or very long queues) of people waiting to see them. Third, people will have little choice as to the specialists or hospitals to which they are sent, and they will find themselves deprived of choice and entirely dependent on a state-controlled monopoly,” said Mdluli.
The NHI Bill was introduced in Parliament in August 2019, and it was subsequently referred to the committee for consideration.
According to the state, the NHI Bill seeks to realise universal health coverage for all. This means that every South African will have the right to access comprehensive health-care services free at the point of care at accredited health facilities such as clinics, hospitals, and private health practitioners.
In his speech in Parliament, the Minister of Health, Dr Mathume Joe Phaahla, said the NHI sought to pool the resources of those who could only contribute to the fiscus through indirect means such as VAT and other collections and those who were able and were already making fragmented contributions into 81 different schemes into one pool that can purchase services from both the public health system and private providers from the lowest level of care up to the highest.
“In doing so, we can achieve access, equity, and quality but also drive down costs. I know that there are those of you in this House and outside who say that NHI is unaffordable, but you are basing this on the highly inflated costs among some of the private providers who are under pressure to keep delivering super profits even higher than gold and platinum mines,” said Phaahla.