The National Department of Health (NDoH) has initiated dialogue with private healthcare providers, changing its previous stance on the role of private healthcare providers under National Health Insurance (NHI).

The Department’s Director-general, Precious Matsoso, recently met with private funders, who have complained about being side-lined on their envisaged role under the proposed NHI, saying they should work together with the government in reforming healthcare is SA.

During the meeting, Matsoso called on the bodies representing medical schemes, among others, to come up with innovative and inclusive ideas on what they envisioned their role would be under NHI.

Association Chairman, Graham Anderson, told Business Day that the call for private sector participation was an encouraging development because medical schemes had previously felt alienated.

“We have the infrastructure to look after 8.5 million people and could expand it to look after anyone who can afford to pay for NHI,” said Anderson. “The rest of the patients would be subsidised or whatever the department decides.”

Matsoso proposed that medical schemes develop comprehensive benefit cover suitable for all lifestyle measure groups.

Anderson said industry funders needed to get together to take advantage of the opportunity presented to them to assist the government — especially the chance to work out finer details, such as where patients would receive treatment under a health system that promoted universal coverage.

Currently, the controversial White Paper on NHI proposes mandatory membership of NHI and a reduced role for medical schemes to providing only ’complementary services‘. However, Health Minister Aaron Motsoaledi has signalled a potentially softer approach, saying medical schemes would continue to exist in the transition to NHI.

The Minister is expected to present a revised version of the White Paper to a cabinet subcommittee, where the future role of SA’s medical schemes and administrators will be scrutinised.

If the subcommittee approves the blueprint, it will then be considered by the Cabinet. If the Cabinet approves the plans, the legislative process to enact the policy will begin.

Zola Mtshiya of the Board of Healthcare Funders (BHF) said the organisation was excited the department wanted to work with the private sector. “This is consistent with what [the board] has been saying all the years.”

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