THERE has been much speculation about the introduction of the National Health Insurance (NHI) in South Africa and a bill has now been passed by Cabinet — next is public participation and then Parliament, with 2020 being mooted as the starting date. The main objective is to give all patients access to all medical facilities in the country, both public and private. Anyone who needs a particular service, not available in the public sector, will be able to access such in a private hospital without been required to pay.NHI is a health financing system which pools funds to provide services to all, irrespective of their socio-economic status. No fee will be charged — the NHI will cover the costs. Public and private health care providers will be paid on the same basis.National Health Minister Dr Aaron Motsoaledi states that NHI membership will be mandatory as this is the only way it can work; if we all belong to the system.Government currently pays for the facilities that assist those not on medical aid as well as tax subsidies for medical scheme contributors.However, he says, medical aid members who wished to retain their membership and pay for themselves could do so.He states that it will reduce the cost of private health care, but will still provide a good income for professionals and institutions in the private sector. However, the NHI use a more cost effective method of payment than the one currently used by medical aid schemes.The minister admits that there will have to be a massive re-organisation dealing with the quality of service in the public health care system prior to the introduction of the NHI.