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Quality healthcare needed now as President signs NHI Act

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.”