Thandi Skade and Anso Thom
Taxpayers, get ready to part with more money. Although exact figures of how much you will have to contribute towards the National Health Insurance (NHI) fund remains unknown, what is certain is that you will have to pay – whether you use the services of NHI-contracted hospitals and clinics or not.
And if you choose to seek medical services from hospitals and clinics not contracted to the NHI, you will have to pay whatever fee the doctor charges out of your pocket or through a medical aid scheme – on top of your NHI contribution.
But if a private doctor, hospital or clinic is part of the NHI, then you will pay the system’s rates.
Yesterday, Health Minister Aaron Motsoaledi released a green paper on the NHI saying it would be implemented over 14 years, with the first five years used to put “critical building blocks in place”.
He explained that the NHI would be divided into three stages over the 14-year period, the first stage being “intense preparation”.
Priorities include the establishment of the NHI fund and the drastic improvement of infrastructure, patient treatment at hospitals, human resources, management systems at hospitals, information systems and quality control.
Finance Minister Pravin Gordhan said money for the NHI fund would be generated through tax, mandatory contributions from employers, patient co-payments, and public and private partnerships.
According to the green paper document, R125 billion will be required for the NHI to work in 2012, increasing to an estimated R255bn in 2025.
The improvement of the health system will be piloted in 10 sites from April.
“We have not yet decided which sites we will target, but it has to be a mix between richer and poorer districts so we can ensure we get it right,” said Motsoaledi.
An independent audit is under way to determine public health care facilities’ compliance with quality standards in preparation for the NHI roll-out.
So far, 29 percent of the 4 210 state facilities have been audited, with the aim of completing 94 percent of the facilities by the end of March.
Motsoaledi said the introduction of the NHI would not mean the abolishment of private medical aid schemes, nor was it a “war” between the public and private health-care sector, but rather an opportunity to draw from the strengths of both sectors to better serve the public.
Private sector providers who want to participate in the NHI would need to comply with quality standards, provision of a package of services, including the prevention of diseases, and the promotion of health and “acceptance of capitation as a method of payment instead of fee for service and appropriate pricing mechanisms”.