NHI: what is the time frame?

In his State of the Nation address on 2009, President Jacob Zuma announced the introduction of a National Health Insurance system. We're in possession of the confidential document in which an ANC task team sets out its NHI plan. Here are the details of the timeframe on which the NHI is structured. By Mari Hudson, for What’s New DOC

Timeframe set out in the NHI document

  • The White Paper on NHI should be ready in 2009 or early in 2010.
  • Draft legislation should be ready by March 2010 (nine months from now).
  • The new NHI Bill should be passed by Parliament and promulgated by the President as early in 2011 as possible.
  • All structures to start implementing must be in place by March 2012.


Plans for the pre-NHI phase (to achieve implementation by March 2012)

  • 2009: Costing models to be presented to the ANC. (First indications are that 5% of GDP is needed to establish a NHI system in South Africa).
  • 2009-2013: Registration of the population per health district at a rate of 25% of the population per year. There is no opt-out option.
  • 2009-2013: Establishing and strengthening the provincial health authorities (this is in direct contrast to the Roadmap proposals).
  • 2009 – 2013: The phased accreditation of all public health clinics and hospitals and all private GPs and private hospitals, who wish to be contracted. The refurbishment and expansion of the public health care sector willbe undertaken with accreditation in mind.
  • 2010 – 2013: Increasing the health budget from general tax revenue in real terms (from 11% to 14% of total Budget), starting the implementation of mandatory payroll levies to be paid by all employees and employers in the formal sector (with no opt-out option), and the immediate rerouting and transfer of all funds of GEMS and other public sector medical schemes to the NHI Fund. All medical scheme contributions by employers and employees will be taxable.
  • 2010-2013: Increasing human resources in the public sector.


After promulgation in 2011 of the new bill, the following structures will be established before 2012: The NHI authority (NHIA), NHI provincial subauthorities, district health committees and several technical advisory committees (including audit, pricing, remuneration, benefits and other advisory committees) for the NHIA.

Plans for right now
“Further progress in developing and implementing a better health financing system is currently in the hands of the NHI task team, the DoH, National Treasury, SARS, the department of social development, (designated) members of the ANC and its allies, as well as health professionals operating in the public and private health sector. The Task Team will include a dedicated team of international experts and specialists,” the NHI document states.

Anything to add? Mail Health24 on feedback@health24.com to let us know how you feel about this issue. This is an edited extract of an article that originally appeared in What's New DOC, the new magazine for doctors produced in association with Health24.

Read more:
The ANC's NHI Plan
How will the NHI work?

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