South Africa stands at a pivotal moment in its pursuit of universal healthcare with the impending implementation of the National Health Insurance (NHI) Bill.
The NHI Bill has been passed by parliament and awaits approval by the National Council of Provinces before being signed into law by the President.
While the NHI holds the promise of achieving universal access to healthcare, Craig Comrie, CEO of leading medical scheme, Profmed, highlights critical concerns that could hinder the progress and compromise the quality of healthcare services for all South Africans.
“Quality healthcare lies at the very heart of Profmed; thus, we acknowledge the significance of the NHI Bill’s objectives. However, concerns remain regarding certain clauses within the Bill that may impede individuals’ and medical scheme members’ access to essential healthcare services,” Comrie says.
Comrie highlights that without addressing these concerns, the Bill’s implementation in its current form could have far-reaching implications for the healthcare landscape in South Africa, casting doubt on the promised improvements in the healthcare system.
“Throughout the years since its initial proposal in 2009, the NHI Bill has undergone limited revisions despite ongoing engagements with the private sector,” he says.
Comrie emphasises critical issues within the Bill that raise red flags regarding its practicality and impact on healthcare services:
• Limitations on benefits medical schemes can provide
Comrie expresses that medical schemes play a vital role in alleviating the funding burden on the state. “The current failing public health system’s inability to effectively manage the nine million lives covered by medical schemes suggests that pooling these lives could compromise the overall quality of care across both the public and private sectors,” he says.
• Nationalising medical scheme premiums through increased taxes
Comrie questions the validity of claims that consolidating medical scheme premiums and public funds into a single NHI Fund will result in significant cost savings. Insufficient research and lack of clarity regarding the benefits included in the NHI raise doubts about the feasibility of obtaining services at cheaper rates. Furthermore, given the already burdened South African tax base, any additional tax increases may place an unsustainable strain on the economy.
• Exodus of skilled medical workers
“The departure of highly skilled professionals from South Africa in recent years has been attributed to factors such as the difficult economic climate, load shedding, and crime,” he says. “The introduction of the poorly drafted NHI Bill could exacerbate this trend. Without a resource plan or incentives to retain critical medical professionals, the Bill's nationalisation of their services under a single-payer system poses a significant risk to the availability of skilled healthcare providers.”
“Working alongside industry bodies like the Health Funders Association and Business Unity South Africa, Profmed advocates for a reassessment and retraction of the current NHI Bill, aiming to influence healthcare policy and create a realistic, sustainable system that ensures access to care while fostering the growth of South Africa's economy,” he says.
For him, comprehensive dialogue and careful consideration of these concerns are vital to developing an inclusive healthcare system that fulfils the needs of all South Africans without compromising the quality of care.
“We urge policymakers to address these concerns in order to ensure that the implementation of the NHI Bill aligns with the overarching goal of achieving universal access to quality healthcare for every citizen of South Africa,” Comrie concludes.