NHI funding model gives medics headache

2014-10-15 17:43

Fears about how the National Health Insurance (NHI) system will be packaged have once again come under the spotlight.

This time the private healthcare sector, private hospitals in particular, expressed concerns about revenue collection, reimbursement of service providers as well as what benefits will be covered by the system.

This concern was raised at the Hospital Association of South Africa’s annual three-day conference currently taking place in Sandton, Johannesburg.

Up to now, there is no clear indication about how the NHI will be financed, what benefits will be covered and how much private doctors and hospitals who have treated patients will be reimbursed. The white paper on NHI, which is supposed to have all this information, is still in the making more than two years after it was expected to be published.

All that has been revealed by Health Minister Aaron Motsoaledi is that NHI will be a single-payer system which means that government will organise healthcare financing – revenue collection and reimbursements. Taxes and employer contributions will be the main source of funding for the scheme.

NHI will work more like a medical scheme in that patients will go to private doctors and access treatment without paying upfront. Government will then reimburse doctors based on tariffs that are still to be decided.

Dr Nkaki Matlala, executive director at Mediclinic, one of the biggest hospital groups in the country, told delegates that the single-payer system and the purchasing power that government would have under the NHI makes him nervous because of previous experiences.

“What we know right now is that government will have the monopoly of negotiating tariffs and prices will be kept down.”

However, Motsoaledi assured delegates that there was nothing to worry about as the NHI was not meant to punish the private healthcare sector but strengthen the health system of this country.

“The NHI will ensure that every person living in South Africa has access to quality healthcare irrespective of their social and economic status. We need the private sector to work with us towards universal coverage so more South Africans could access quality healthcare,” appealed Motsoaledi.

He also urged delegates to embrace the changes currently taking place in the health sector in South Africa. He was referring to the NHI and the National Development Plan (NDP) which has placed health as a key priority in the next fifteen years.

The NDP talks in length about the importance of raising life expectancy, drastically reducing HIV infection in young people as well as creating efficient health systems that provide quality healthcare.

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