Better health for all

2010-09-22 00:00

MILLIONS of poor South Africans who are not covered by medical aid schemes are likely to start benefiting from the national health insurance (NHI) scheme by 2012 — and new taxes will pay for universal health coverage.

In a report presented to the national general council (NGC) of the ANC, the party’s health sub-committee chairperson, Zweli Mkhize, proposed that the implementation of NHI be phased in over 14 years, with the roll-out to start in 2012 in seriously under-served areas where people have difficulty accessing healthcare.

Mkhize said key proposals of the report are that NHI will be founded on the principles of the right to health care, universal coverage, social solidarity and a single public administration in which access to health will be based on need rather than on ability to pay.

“A public administered NHI fund — operating like SARS [South African Revenue Services] and situated within the Ministry of Health — will be created to receive funds through a single-payer system.

“This refers to one entity acting as administrator, or ‘payer’, set up by the government to receive all healthcare funds and pay out all healthcare costs for all SA citizens and legal residents through a single insurance pool,” Mkhize said.

The fund will provide comprehensive cover for health services — primary, secondary, tertiary and quatermary (high-care services) — which will be offered by accredited public and private health providers to ensure quality healthcare standards.

Mkhize said at the core of NHI will be primary healthcare, the first point of entry to the health system.

Membership of the NHI will be compulsory for the whole population, but individuals can choose to continue voluntary medical scheme cover.

The report foresees a “re-engineered primary healthcare system” served by teams consisting of a doctor or clinical associate, a nurse and three to four community health workers.

Proposed funding methods include a surcharge on taxable income, payroll tax revenue (for employees and employers) and an increase in value-added tax earmarked exclusively for the NHI .

Mkhize said preliminary costing estimates indicate that resource requirements under this model would be R128 billion in 2012, increasing to R267 billion in 2020 and to R376 billion in 2025 in current financial terms.

“The NHI will provide comprehensive quality healthcare at less than the current spending by the public and private health sectors,” Mkhize said.

A member of the ANC health sub-committee, Dr Olive Shisana, said the reasoning behind the scheduled launch in 2012 is to start consultations with all stakeholders and to give time for the drafting of new legislation to set up the NHI.

In an interview with The Witness, independent health consultant Dr Victor Ramathesele welcomed the move, saying it will help provide quality healthcare for all South Africans.

Ramathesele said the success of the scheme will depend on the input from all stakeholders and how it is received by society.

More coverage of the ANC’s NGC: page 4

n Access regardless of ability to pay.

n Compulsory; option of contributing to a private medical fund remains.

n Fund will be administered by the government in the same way as the SA Revenue Service functions.

n Services provided by accredited private and public hospitals.

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