Free – but at huge cost

By admin
01 October 2010

It was first mooted in 1994: equal, quality healthcare for all South Africans.

With our public health system chronically requiring intensive care, a few years ago the ruling ANC started serious discussions about national health insurance (NHI) in an effort to provide healthcare to all.

After an uneasy silence and criticism about the cost and viability of such a system it was announced at the ANC’s recent national general council that NHI will be pursued – in fact the party wants to begin as soon as 2012.

The ambitious NHI plan is considered by many to be a controversial concept and taxpayers are shuddering at the thought of handing over more cash to the Receiver. No matter what slant you put on the story, good healthcare for all will cost a lot of money.

The details of what NHI involves and how it will be instituted and financed must be thoroughly explored. The discussion document that caused a stir is still only a party political policy document, not official government policy. Extended consultation with all interested parties, changes to legislation and regulations and so on still lie ahead.

Meanwhile here’s a brief look at the most recent NHI proposals.

“There’s a strong social and economic case for the implementation of NHI without delay,” ANC spokesman Jackson Mthembu says.

Key proposals include that the NHI be based on the right to healthcare and universal coverage.

An NHI Fund (NHIF) will be created that will function like the SA Revenue Services and will be within the health ministry. All contributors will pay into one fund, rather than the present system by which members pay into various medical funds.

One entity, the NHIF, will receive and administer healthcare money and pay healthcare costs for all citizens and legal SA residents, Mthembu says.

Measured by the latest proposals NHI membership and therefore contributions will be compulsory for all. The more you earn the more you’ll contribute.

If you’re unemployed or earn less than a determined amount you won’t have to contribute although everyone will enjoy the same quality of healthcare.

Those who can afford it will be able to continue with medical-scheme coverage. Private healthcare providers will have the right to decide whether they want to be part of the NHI system or not.

The ANC’s NHI planners estimate the costs of a “universal health system” will ultimately make up 7,8 per cent of gross domestic product.

Proposals include significantly increasing funding of the health sector from general taxation. Surcharges on taxable income and payroll taxes and an increase in VAT earmarked for the NHI are being considered.

Read more about it in YOU, 7 October 2010.

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