NHI not designed to destroy private healthcare, says Motsoaledi

Johannesburg - The pursuit of a National Health Insurance is not intended to destroy the private healthcare sector but to allow more South Africans access to quality healthcare, Health Minister Aaron Motsoaledi said on Tuesday.

“There is no plan, secret or otherwise, to destroy private healthcare providers in the country. What we are saying is that private healthcare has a lot of resources which are not available to everyone.

“We are not saying it must be destroyed [but it should] make it possible for [them] to be utilised by all South Africans,” Motsoaledi said.

He was addressing reporters at a Board of Healthcare Funders of Southern Africa briefing. The organisation is made up of members including medical schemes, administrator organisations as well as managed care organisations.

BHF has thrown its support behind Motsoaledi but has questioned how the NHI plan will be funded and sustained.

The white paper on the NHI was released for public comment in December 2015 and the industry has raised its concerns on how it will be funded amid the country’s current economic environment.

Motsoaledi said there had been a number of negative comments around the NHI and that certain people and organisations were using “scare tactics” to sway the public’s opinion.

He accused detractors of chasing selfish intentions. The NHI was an idea which was in line with United Nations development goals which all other countries were signatories of, he said.

Massive transformation

“The UN has adopted the concept of universal health coverage for all. All countries falling under the UN are signatories,” he said.

The emphasis was in the words “for all” which meant all South African citizens had the right to quality and efficient healthcare. For this to be done, the current health care system needed a complete overhaul.

“We need a massive reorganisation of the healthcare system, both public and private. By massive change I make an example of when a butterfly metamorphoses from an egg to a worm to a butterfly.

“A butterfly is not just a bigger worm; it is a completely different picture all together,” Motsoaledi said.

“That is what we are planning, we are planning complete metamorphoses of the health care system because we can’t accept what is happening now. It is not good.”  

He said currently, 80% of the country’s specialists were in the private sector and only catered to 16% of South Africa’s population.

“We don’t see any other way of sharing resources. It must be available to all South Africans… No one should be left behind.”

He said those who criticised the NHI, were not criticising the entire plan, they just wanted it to be available for a selected few, he said.

“We don’t want that,” Motsoaledi said.

Motsoaledi also denied claims that the NHI was an attack on the middle class, saying only a small percentage of the middle class could actually afford to pay their current medical aid premiums.

The majority of them were being “squeezed” financially, he said.

One of the highest medical aid premiums in the world

He said a number of South Africans who were part of medical aid schemes were often turned away from private hospitals if they did not have sufficient funds needed for their treatments, and eventually ended up being admitted and treated at public hospitals.

Motsoaledi said South Africa was paying one of the highest medical aid premiums in the world. Making an example of himself, he said he was paying R14 000 a month for his medical aid scheme which only served members of parliament and judges.

He said his benefits often ran out before the year had come to an end. 

The private healthcare sector was making billions and it needed to be monitored closely to ensure that the prices would not increase exorbitantly, he said.

“In 2002 expenditure for private care was R22bn. In 2014 it was R140bn. When you draw up a graph it tells you that in 2018 it is going to be half a trillion rand to cover 16% of our population.

“If that is not exorbitant then what is?” he said. 


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