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Spotlight ?: NHI

We’re introducing a new feature that provides a summary and the latest update a long-running issue in our country. This week we’re looking at the country’s National Health Insurance. The report of the first phase is out and there are some interesting developments – particularly since Zweli Mkhize took over from Aaron Motsoaledi as Health Minister earlier this year. 

NHI in a nutshell:

  • Started in 2012, and is being implemented in three phases over a 14-year period.
  • Aims to provide universal healthcare to all South Africans of the same quality, regardless of income
  • Is hampered by a) The shocking state of public healthcare and b) Opposition from private healthcare, which a recent provisional report by the Competition Commission has found generally overcharges AND overtreats those who can afford medical aid, with little competition between schemes.

Latest update

There have been a number of developments on the health front recently: here are five summarized.

1. An independent report into the first phase of the NHI roll-out was released this week. The first phase was a pilot that ran until the end of 2017. The results of the report are… a mixed bag. It’s not quite the complete disaster many feared and as those in charge of the study pointed out, the purpose of this phase was to act as a pilot so that government could learn what to do better. We’re currently in the second phase (2017 – 2022), during which NHI legislation has to be developed and the NHI fund has to be established.

2. Earlier this month, cabinet adopted the NHI bill which was introduced a year ago.  

Here is a graphic summarizing the bill when it was proposed in June 2018.

There are concerns about the bill but…

3. In his first budget speech on 12 July, new health Minister Zweli Mkhize pointed out that no country has been able to wait till things are perfect before rolling out universal healthcare – which is true. He is intent on getting the ball rolling.

4. On Thursday Cyril Ramaphosa signed off the Presidential health Compact. This is a blueprint for fixing SA’s healthcare. It’s part of a larger movement that has seen a number of struggle stalwarts come together to form the Progressive Healthcare Forum. It turns out there’s actually a lot of consultation happening and Mkhize is a good listener. His budget speech was passed by civil society, activists and he is engaging with the forum. This is good news as…

5.  A scenario planning exercise held by the Board of Healthcare funders (mostly the private health sector) this week found that the best-case scenario for the future of health in our country would be strong, clear leadership from government, and a framework that enables all players to collaborate – with a role for the private sector and a successful NHI roll-out.

For more on the NHI, here are three articles we’ve found useful:

  1. Bhekisisa on the latest on the NHI plus the social compact forming between different players:
  2. The Competition Commission’s provisional findings on the problems with private healthcare, neatly summarised in ten points by Health24:
  3. Sunday’s City Press has a nice overview on scenario planning on the future of health care and the report on the first phase of the NHI. You can find it on page eight of the newspaper or online once it is published on their website this week, probably under the headline: “Can SA rescue its health system?” and “NHI’s hits and misses”. It’s also available via Press Reader at a fee here:

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