Multiple roads to Universal Health Coverage based on social solidarity

Thursday 16 May 2024: The process towards fulfilling the promises of the National Health Insurance (NHI) will be a complex and unprecedented process that will necessitate extensive reorganisation of the healthcare sector. As such the experience for most South Africans will not meaningfully change for years to come with hopes having been raised of achieving Universal Health Coverage (UHC) through the NHI Act.

“There are various paths towards Universal Health Coverage [UHC], and collaboration with private healthcare funders can bring the benefits of more equitable access to quality healthcare to millions more South Africans,” says Craig Comrie, Chairperson of the HFA.

“The signing of the National Health Insurance (NHI) Bill into law by President Cyril Ramaphosa will shape South Africa's healthcare future, yet at present there is no threat to medical scheme members’ benefits as the implementation of the NHI Act will be constrained by significant financial and structural constraints and complexities, not to mention legal challenges.

“Until the NHI Fund and public healthcare system are ready to support quality, dignity-affirming healthcare, private health cover could offer an effective means of elevating the standards of care and extending access to millions more South Africans. With the finalisation of long-awaited regulations such as those pertaining to Low Cost Benefit Options (LCBOs) and regular Prescribed Minimum Benefit reviews, real and lasting progress towards the goals of UHC could be made,” Comrie says.

“We remain concerned about the long-term implications of certain sections of the NHI Act and its ramifications for the quality of healthcare for all South Africans, the sustainability of the healthcare system, and by extension, the rights of patients to quality care.

“What is needed is for all in the healthcare sector to unite our efforts to build a workable integrated funding system incorporating multiple funding streams and collaborative engagement to benefit everyone in South Africa. There are workable alternative approaches which can achieve universal healthcare without compromising the freedom of individuals to choose how to fund their healthcare needs,” he notes.

“Where constitutional and other legal issues exist, we will take the necessary action to protect the constitutional rights of individuals and their medical scheme benefits,” Comrie says.

“The NHI Act in its current form will not achieve equity in healthcare and there are better ways to achieve the genuine objectives of Universal Health Coverage. We take the duty to protect access to quality healthcare in line with citizens' constitutional rights very seriously and will not be deterred.”

Disappointment as President prepares to sign flawed bill

Tuesday, 14 May 2024 The announcement that President Cyril Ramaphosa will sign the National Health Insurance (NHI) Bill into law this week without seeking much-needed revisions is disappointing, although not unexpected, according to the Health Funders Association (HFA).

"The HFA has been preparing for this day, despite our strong belief that a more collaborative approach between the public and private sectors is essential for achieving Universal Health Coverage [UHC] in a timely and effective manner," says Craig Comrie, HFA Chairperson.

"We are deeply disappointed that the opportunity to review certain flawed sections of the NHI Bill has been missed, as the HFA sees enormous potential for leveraging the strengths of both public and private healthcare to expand access to quality care for all South Africans.

“Throughout the NHI Bill's development process, the association submitted recommendations centred on collaboration and maximising the sustainability of healthcare provision through the use of a multi-funding model to build the South African healthcare system,” he says.

“Even with the President signing the NHI Bill into law on Wednesday, there will be no immediate impact on medical scheme benefits and contributions, nor any tax changes. The HFA is well prepared to defend the rights of medical scheme members and all South Africans to choose privately funded healthcare, where necessary.

“Our focus, as always, is on protecting and expanding access to quality healthcare for all South Africans. As we await the finer details of the President’s signing, we wish to assure all South Africans that we are ready for this next step,” Comrie says.

“The HFA will continue monitoring developments closely and share updates as necessary. Our goal remains the same: a healthcare system that works for all South Africans, and we will take all necessary actions to support that goal.”