Health Minister promises baby steps on National Health Insurance

Health Minister Dr Zweli Mkhize, under severe pressure from critics of Government’s National Health Insurance (NHI) plan, has promised that discretion will be the better part of valour as the state lays the foundations for the implementation of the controversial new policy.

The DA has warned that the South African government has neither the expertise nor the money to implement the policy, that it will bankrupt the country, cause doctors to leave the country en masse, destroy the only part of the health system that works and terminally undermine freedom of choice in the health sector. 

Initial NHI pilot projects failed miserably

The first NHI pilot projects were absolute disasters and even the EFF, which supports the NHI concept very strongly, has begun to question the state’s ability to implement it successfully as anecdotal evidence mounts of an avalanche of top doctors considering the option to quit South Africa.

Mkhize has made several promises that the NHI will be implemented incrementally, in a way that takes note of criticisms, improves as it goes along and does not bankrupt the country.

Give credit where it is due: The initial districts where the NHI will take effect are areas far from the bright lights, big cities and citadels of world class private medical care.

These are districts where patients are just about universally dependent on public (state) healthcare anyway, so to be brutally honest chances are that services for them may well improve under any new system.

National Health Insurance: More details emerge

In a presentation by the national department of health before the parliamentary portfolio committee on health in Cape Town yesterday, top departmental officials firstly dealt with the technical details of the new system.

They confirmed that once NHI is implemented, private medical schemes will only be able to provide coverage for services not rendered by NHI. Put differently, in the way it is currently planned, it seems doctors who provide services covered by NHI would not have the option of working outside NHI, and patients would not have the option of using any doctors as service providers for those NHI covered medical services, save for the doctor the NHI decides you must use.

In reaction to the DA’s concerns that the NHI Bill currently before Parliament is unconstitutional as it reduces the powers of provinces, the officials argued this is not the case as provinces will still be the implementing agents, run ambulance services, monitor and control service delivery levels and delegate hospital services etc.

The battle has about the future shape of South African healthcare has started, and it is a battle royal which will clearly have massive implications any which way it goes.