Proposed National Health Insurance Explained

The income disparities in South Africa are tremendous. With the high cost of healthcare, most people can afford only the public healthcare facilities. This results in a tremendous burden on the public healthcare system, which is also underfunded.

The private healthcare facilities are used by a smaller percentage of employed individuals with higher purchasing power. The private facilities are better funded, with more sophisticated equipment and technology, not to mention better staffed.

The irregularity of healthcare in private and public facilities has resulted in a wider gap between the qualities of the two. National Health Insurance (NHI) is a health scheme proposed by the South African government to provide medical aid to every citizen of South Africa.

The NHI aims to provide healthcare to everyone regardless of their income and employment status. The insurance will cover a comprehensive package of predefined healthcare needs.

It has been proposed that the contribution towards NHI will be obligatory for people earning above a certain monthly income. This threshold has yet to be identified. The contribution towards the NHI would be compulsory.

However, the citizens are free to choose private medical care if they do not wish to utilise the services of the NHI accredited facilities. They can also opt for private medical insurance schemes or pay for the private services with their own funds.

The private medical aid companies would still operate for those who prefer private aid. People who do not wish to leverage the services offered by NHI could opt for the private medical care.

However, the medical care providers who wish to participate in the scheme would be required to meet certain standards that will be laid down. The NHI is envisioned as a catalyst that would improve the standard of care, preventive mechanisms and pricing of healthcare services.

Benefits of NHI

1. The most obvious benefit of NHI is the long-term equitable access of healthcare facilities, preventive mechanisms, and treatment for all.

2. The comprehensive health benefits through NHI would cover all aspects of healthcare holistic healing, including preventive and rehabilitative.

3. By improvement in infrastructure and staffing, the public healthcare services would be vastly improved. The cost of private healthcare is currently incredibly high and inaccessible to the vast majority.

4. With the improved facilities of the public healthcare systems, the dependence on private would be reduced. This will also bring down the cost of private healthcare through competitive pricing.

Limitations of the NHI

1. The strongest criticism against NHI is the lack of clarity in the mechanisms that will bring about the change in healthcare facilities.  A comprehensive benefit package has not been defined and funding needs have not been determined. The viability of NHI is thus under question.

2. The NHI is based on the assumption that private healthcare is responsible for the lack of success and poor quality of public healthcare. However, the evidence for this argument is not provided by the government. Many criticisms for this assumption have been made.

3. Another denunciation of the NHI scheme viability is lack of manpower to operate the public healthcare system. Though the government has promised full staffing throughout the public healthcare facilities, they have failed to mention how this staffing crisis will be addressed.

Thus, the NHI green paper, though it has a meritorious sentiment behind it, seems to be lacking in a fundamental question of how the inadequacies of the public health systems will be overcome.