Even though the NHI Bill is moments away from becoming an Act of Parliament, the South African Medical Association (Sama) believes that the bill is being used as an electioneering tool, and that it doesn’t hold the interest of the poor and that of the collective medical sector.
There’s only one step left before the National Health Insurance (NHI) Bill is signed into law by President Cyril Ramaphosa; this follows its adoption by the National Assembly on June 13.
The Department of Health briefed the National Council of Provinces (NCOP) on the Bill on Tuesday, and if it is adopted by this house, it will go to the president, who may sign it into law.
The bill promises a number of things, such as the creation of the NHI fund that will cover all South Africans and foreigners who hold legal status in the country.
Among other promises, the bill states that when people visit health-care facilities, there will be no fees charged because the NHI fund will cover the costs of people’s medical care in the same way that medical aids do for their members and that the cost of health care will be reduced.
Sama chairperson Dr Mvuyisi Mzukwa, who has launched an online petition against the NHI Bill, said in its current form the bill is problematic and that it doesn’t clearly state where the money for the fund will come from.
“Sama has consistently voiced objections, emphasising that the bill's current form is problematic. Key concerns include the focus on a funding model without addressing human resource shortages and infrastructure issues in the public health-care system. Corruption risks, a lack of cost assessment, and limitations on medical aid schemes are additional worries. Sama emphasises the need for comprehensive reforms to achieve universal health coverage effectively,” said Mzukwa.
Mzukwa accused the department of using the bill as an electioneering tool, saying that since 1994 the government had failed the people of this country by not providing basic services such as water and electricity, and that the fund would be another failed project.
“By the look of things, we are only addressing health issues, but not all the determinants of health, such as socio-economic issues, the environment, and so on. We are also going to need more doctors and good leadership in government, as we know corruption is rife in the country, and I am afraid the NHI fund won’t be immune to that, hence, we need measures in place to guard the fund against corruption,” said Mzukwa.
He said stakeholders, particularly health-care professionals, were not opposed to the principle of universal health coverage that the bill aimed to achieve, considering the urgent need for an overhaul of the dilapidated and understaffed public health-care system and the unaffordable private health-care system. Their opposition lies in the solution presented by the NHI Bill.
Minister of Health 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 could purchase services from both the public health system and private providers from the lowest level of care up to the highest.
“We accept that the NHI will not be the silver bullet that will fix all our health problems, but it is the necessary foundation to build on for a progressive improvement of access with quality and equity. We must work together to build our own National Health Service,” said Phaahla.