Following the release of the widely anticipated policy paper on NHI in December 2015, the government’s plan to reform SA’s healthcare system has been widely criticised as unaffordable, and seen to limit the benefits offered by medical schemes.

The Democratic Alliance (DA) has been vocal in its opposition to the ANC’s NHI vision and recently unveiled its answer to universal healthcare: Our Health Plan. According to the DA, unlike NHI, their plan is a better deal for patients and can be rolled out in half the time and at no extra cost to the fiscus.

The party says its proposed plan is the most practical approach to universal healthcare, as it aims to keep what should be kept, fix what should be fixed, and smartly extend services that should be extended within the limits of the national purse.

The DA is promising  faster delivery of its health plan (5-8 years) as opposed to the 14 years promised by the ANC-led government when it published its NHI Green Paper in August 2011.

“We believe our offer is the most credible and workable option that seeks to ensure that no person is denied quality healthcare because they are poor,” said DA shadow Minister of health, Dr Wilmot James.

According to the DA, its plan aims to introduce strategic reforms to upgrade the public system, introduce greater competition in the private system and encourage more organised public private partnerships (PPPs).

The DA’s plan proposes scrapping medical aid tax credits, which are valued at R17.4bn for the current fiscal year, and using the resources to improve public healthcare and subsidise medical scheme membership.

“Our Health Plan will provide quality healthcare to all at a cost that we as a country can easily afford. It can be implemented using our current health budget, but with an additional R6 billion achieved by bringing the current medical aid tax credit of R17 billion on budget,” said Dr James.

“This would mean that medical aid contributions would no longer be tax deductible. However, the remaining R11 billion of additional revenue would go to reducing the costs of medical aid. NHI on the other hand is budgeted to cost up to an additional R182 billion per year, which we simply cannot afford,” continued Dr James.

By bringing the medical aid tax credit on budget, and allocating some of it to build better services in the public health sector, those with medical aid are cross-subsidising those without, an act of health justice, according to the DA.

For South Africans who don’t have medical aid, the DA says its reforms will deliver improved service at clinics and hospitals, enhanced maternal and child care provision and access to efficient – and free at the point of service – emergency services in urban and rural areas, while those on medical aid will benefit from enhanced choice and greater access to more efficient – and free at the point of service – ambulance services.

The DA envisages a system in which a universal health subsidy is allocated to every citizen and legal resident, the value of the subsidy would be set in relation to an affordable and comprehensive package of services available within the public health system.

The plan also proposes to eliminate the means test used in the state sector, so care will be free at point of service for both those who have medical aid membership and those who do not. Medical schemes will pay in a more structured manner for public services used by their members as the quality thereof improves.

“This entire plan is realisable within our current resource envelope meaning we can achieve universal healthcare for all, without requiring any new or additional taxes,” concluded Dr James.

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