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Updated 16 August 2013

NHI: where are we now?

National Health Insurance: when and how? These will the big questions central to the meeting of the Board of Healthcare Funders (BHF) in Cape Town next week.

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Set to run from 18 to 21 August at Cape Town’s International Convention Centre, BHF’s 14th Annual Conference will concentrate on harnessing the power of the healthcare industry and encouraging members to work together.

Speaking to Health24 ahead of the conference, Dr Humphrey Zokufa, BHF managing director, said that while serving the medical scheme population and growing the industry is the board’s motivation, public healthcare was of equal importance.

“By collectively mobilising the private healthcare sector, we are also indicating our determination to play an important role in the government’s proposed National Health Insurance (NHI) plan.”

Considering the appalling state of the country’s public healthcare system, the NHI plan is expected to be the catch-all solution and aims to ensure citizens are provided with essential health care, regardless of their employment status and ability to make a direct monetary contribution.

However, the NHI plan has been in the pipeline since 1994 and as it starts slowing being implemented, the range of public concerns are along the lines of “when, how, and to what ends?”

The lowdown on NHI
  • The ANC Health Plan of 1994 outlined a structure for a National Health Insurance system.
  • From 1994 to 2003 there were a series of committees of inquiry and task teams that confirmed the need for the reform of healthcare financing and provided more detail on specific aspects of the proposal. While substantial work was done by the Department of Health until 2005, these documents were not in the public domain.
  • From mid-2008, the ANC worked on a revised vision of the NHI and a party document was released in late September 2010.
  • The National Health Insurance (NHI) Green Paper, to encourage public opinion, was released on 11 August 2011.
  • In 2012, the Health Minister launched 10 pilot projects to assess various policy options for NHI.
  • The projects were set up in all provinces and covered 10 million people.
  • The government confirms NHI is to be phased in over a 14-year period beginning 2013.
  • The NHI programme will be 32 years old by the time the public fully benefits from it.

Love/hate relationship

The relationship between the government and the private health sector has always been a contentious one.

SA Human Sciences Research Council chief executive, Dr Olive Shisana, even went so far as to accuse the private sector of discouraging the government from implementing the NHI scheme for many years.

However, BHF’s Dr Zokufa, maintains that the NHI plan could be successful through partnerships, and he aims to lobby the government on the matter.

“We [BHF] have expressed our interest to partner with the government on NHI. However, there remains uncertainty, even among government official, about whether this will happen,” said Zokufa.

Zokufa says his organisation is busy drafting a comprehensive proposal on how the government can use the proven model of private healthcare to the advantage of the NHI plan.

“It should not have to be about starting from scratch. It’s really a case of using what is already there, and then making it more accessible to the general public,” he said.

Minister of Health, Dr Aaron Motsoaledi has previously expressed how the National Health Insurance (NHI) plan should not be viewed as a contest between the public and private healthcare sectors.

Addressing the Hospital Association of South Africa Conference in Cape Town late last year, he said: “That is why I want to work with you [the private sector] under the stewardship of the state, but with your participation to come up with solutions.”

The Minister will join BHF and a variety of industry leaders at the Cape Town conference to discuss ways of achieving a viable, affordable and equitable healthcare system.

In an opinion piece by Kate Francis, a Researcher at the Helen Suzman Foundation, she says:  “South Africa has reached the stage where it cannot afford not to develop and implement the correct reforms to the health care system … open, creative and considered discussion is the only path to ensure improvement in our right of access to quality health care for all South Africans.”

Perhaps the BHF meeting will yield some much-needed solutions to the country’s healthcare woes.
 
 
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