Sowetan Thursday July 18 2024
SPECIAL REPORT: MEDICAL COVER OPTIONS
rship
e Paid Partn
11
Critics plan to challenge the bill in court There was significant backlash to the signing of the National Health Insurance (NHI) Bill in mid-May from the medical fraternity, trade unions and even some political parties who called it an electioneering ploy given that the scheme is unworkable and unaffordable in its current format. Both the IFP and the DA rejected the bill, with the IFP calling it “a recipe for disaster”. One of the biggest issues critics have with the NHI Bill is the future role of medical schemes and private healthcare once the scheme is fully implemented. The act states medical schemes will not be able to provide cover for services that are paid for by the NHI. There are a number of organisations who have announced that they plan to challenge the bill in court including the Health Funders Association, the SA Medical Association, the SA Health Professionals Collaboration, Solidarity and the DA. Speaking on behalf of medical schemes at a recent symposium, the Health Funders Association stressed that schemes were not against universal healthcare, but rather the single-payer system NHI plans to implement. Chair of the association’s NHI steering committee, Charlotte Mbewu, said there is not a country around the world that has implemented a similar model that has improved the country’s healthcare system. The association plans to only challenge section 33 of the NHI Bill, which states that medical schemes are only allowed to provide cover for services that are not covered by the NHI. The new government of national unity is unlikely to affect the court challenges. The association has called on medical schemes to reassure its members that their medical cover remains in place. Discovery CEO Adrian Gore sent a notice to all Discovery
Discovery CEO Adrian Gore.
The NHI Bill faces court challenges from various organisations, including political parties. / 1 2 3 R F
Medical aid cover continues despite NHI being enacted members that their medical scheme cover and benefit won’t be affected by the new law for “a long time to come”. Gore said this is because “NHI is an inordinately large and complex initiative that proposes extraordinary change and restructure to public and private healthcare systems. This is unprecedented and will be incredibly difficult to achieve”. Business Leadership SA CEO Busi Mavuso is one of the many critics of the NHI Bill. She accused the government of rushing populist policy through parliament as part of an “electioneering ploy”. She said the signing of the act was “destructive for many stakeholders and relationships at a time when partnerships between government and businesses are critical to building confidence globally that SA is an investable destination”. Mavuso has written that, “the law will never work, simply because there is no capacity to implement it, and as soon it is signed it will be embroiled in litigation on several fronts, including its constitutionality”. Business Unity SA CEO Cas Coovadia has also called the legislation in its current form “unworkable, unaffordable and not in line with the constitution”. Coovadia said the unfortunate consequence of the current NHI version was that it “will hamper, rather
Busi Mavuso
BUSINESS LEADERSHIP SA
vised medical aid members to retain their membership. “There are numerous concerns surrounding the act, particularly around funding, administration and the right to freedom of choice as set out in the Bill of Rights. “There is no detail on how NHI will be funded. The most likely option is additional taxes. Currently taxpayers, including private medical scheme members, fund 75% of the public health budget,” he said. He is also concerned about how NHI will be governed. Medical schemes are strictly
than promote, access to quality healthcare for all citizens”. Medical schemes have argued that limiting their role is counterproductive to the idea of providing universal healthcare because the public healthcare sector does not have the resources to meet the needs of all South Africans. The health ombud has previously told parliament that most public hospitals will not meet the standards required by NHI. Forcing current medical aid members onto the NHI system will increase the burden on public funding. Lee Callakoppen, principal officer of Bonitas Medical Fund, the second largest open medical aid scheme in SA, confirmed that it will take years to clarify NHI and ad-
Lee Callakoppen, Bonitas Medical Fund principal officer.
The law will never work ... there is no capacity to implement it
[NH]I will hamper, rather than promote, access to quality healthcare Cas Coovadia
BUSINESS UNITY SA CEO
regulated, closely scrutinised and undergo public audits. In the same way, NHI will be a not-for-profit organisation owned by its members and strict oversight will be required. The NHI white paper states that NHI will be rolled out in priority areas first including healthcare at schools, childhood cancer, women’s health (including pregnancy, cervical cancer and breast cancer), disability and rehabilitation services as well as hip, knee and cataract surgery for the elderly. “If the NHI is to be rolled out to specific target groups first, what becomes of other people in need?” asked Callakoppen. He believed public and private healthcare should coexist and that medical schemes need to be able to work in tandem with the NHI to prevent duplication of costs. “Universal healthcare is in everybody’s best interest. We need to focus on public and private enterprise working together, strong leadership, accountability and dealing with social-economic issues as an integral part of the process,” said Callakoppen.