We're in the dark about national health insurance

Legalbrief Today

Ordinary South Africans have been left ‘clueless’ about what services they can expect from national health insurance (NHI) and what they can expect to pay for them, not at the point of service, but by way of increased taxation or dedicated NHI contributions. The Helen Suzman Foundation's (HSF) Charles Simkins says it follows that the implications for medical schemes are also unknown, since the draft Medical Schemes Amendment Bill (MSAB) and the draft National Health Insurance Bill (NHIB) specify that medical schemes will not be able to cover services provided by the NHI. In the foundation’s brief accompanying the release of its submission to the Department of Health on the two draft Bills – published on the foundation’s website – Simkins says the MSAB excludes the Consumer Protection Act from applying to medical schemes matters, and it removes limitations of the waiting period for adults, both reducing rights. He says the Bill should not proceed until the final report of the Competition Commission’s Health Market Inquiry has been published. On the NHIB, Simkins points out that since not all services will be covered by the NHI, there will continue to be a two tier system: one part covered by the NHI, the other by medical aids or out of pocket expenses. ‘The implicit assumption in the NHIB is that the two tiers will be distinct. But this is not the way in which users of the public health system operate at present.’ Simkins argues that the NHIB makes no provision for people who shuttle between the two systems. ‘It simply does not consider the possibility,’ he says. For this reason, the foundation believes that the NHIB should be withdrawn, pending a ‘radical revision of approach’. While the foundation supports the introduction of new services in the public health system, its ‘small share’ of the national and provincial public health expenditure is worrying. The foundation is also in favour of cost studies ‘as a continuing programme’. ‘Indeed, had they been done in the past, we would have a better basis for establishing the cost of the NHI,’ he says.

The Medical Schemes Amendment Bill And The National Health Insurance Bill by Charles Simkins, Oct 08, 2018

HSF submission to Department of Health

Draft Medical Schemes Amendment Bill (B – 2018)

Draft National Health Insurance Bill (X – 2018)