imminent publication of the White Paper on National Health Insurance, the
question being asked by many delegates at the Board of Healthcare Funders’ 14th
annual conference is “will it be constitutional?”
meeting, which took place in Cape Town this week, PhD student from Wits University
Paul Wayburne, presented his opinion on how the rights of 8.5 million medical
scheme members can be balanced with the rest of the population.
opinion, the constitutionality of the NHI has not been adequately researched.
of Rights, the cornerstone of our democracy, affirms the right to healthcare
for all people in our country,” he said. “The Bill of Rights is not dependent
on residency, so does that mean that NHI will also provide for unregistered
refugees and illegal migrants? This is something that will have to be
Minister of Health, Gwen Ramokgopa who spoke later in the programme, allayed
some of the delegates’ concerns when she confirmed that the delays to the
issuing of the White Paper were “necessary so that we could engage with the
substantial inputs from stakeholders. The White Paper will be the response that
clarifies all the concerns that people may have”.
comprehensive services envisaged in the NHI are expected by many in the
industry to result in a reduced demand for membership of medical schemes, but
the Deputy Minister said that medical schemes “will be with us for a while” and
reassured delegates that her department would act responsibly in relation to
medical scheme members.
will be allowed to opt out of liability to contribute to the NHI, but that does
not mean that people will be prevented from purchasing products and services.
We do not envisage that the NHI will pay for cosmetic surgery, for example,”
commented that under Section 27 of the Constitution, the state must take
“reasonable legislative and other measures within its available resources to
provide healthcare for all”.
of decisions already made by the Constitutional Court, it is clear that the
emphasis is on an egalitarian approach which allows for different services to
be provided to different people in order to achieve an substantively equitable
means is that it is not unconstitutional to treat people differently so that
they can be given the opportunity to access healthcare. This could take the
form of transport provision for people in rural areas, for example, and not for
people in urban areas who may have easy access to healthcare facilities,” he
scheme members have the constitutional right to not be deprived of existing
access to care,” he said. “The care has to reach a certain level of adequacy,
which will be judged by the court on a case by case basis. They have a right to
pay for additional care, however, the do not have the right to not pay for NHI.”