Last week Health Minister Dr Aaron Motsoaledi unveiled changes to the National Health Insurance (NHI) Bill and the Medical Schemes Amendment Bill, bringing SA a step closer to achieving the government’s aim of universal healthcare.

Speaking at a press briefing in Pretoria, the Minister released the NHI Bill and introduced proposed changes to the Medical Schemes Amendment Bill which aims to align the medical scheme industry with NHI.

According to the Health Minister, the implementation of NHI will need a massive reorganisation of the current health system, both public and private.

Under NHI, the government would purchase healthcare services on behalf of the population through the NHI fund. NHI will pool funds that are contributed by all South Africans, depending on how much they earn, and will provide everyone with access to public and private sector providers.

The government has proposed massive changes to medical schemes, including abolishing co-payments, medical aid brokers and Prescribed Minimum Benefits (PMBs), which the health Minister says will be replaced with comprehensive service benefits.

“The amendments we are introducing are meant to provide much needed relief to patients finding themselves in serious financial hardships,” said Dr Motsoaledi.

“The essence of NHI, which must start now even with the present medical aid schemes, is that the rich must subsidise the poor, the young must subsidise the old and the healthy must subsidise the sick. The present contribution table charges the same rate for a lower income earner and a high income earner for the same benefits. This practice completely negates the principles of income cross-subsidisation,” continued Dr Motsoaledi.

Dr Motsoaledi says medical schemes currently hold R60bn in reserves, equivalent to 33% of their annual premium income and far in excess of the 25% threshold currently required by law. The Health Minister believes that these reserves were accumulated partly through high premiums but also by introducing the co-payments such that medical schemes avoid having to pay or even dip into the reserves if the situation demands.

In a statement sent to eHealthNews, the Health Funders Association (HFA) said it welcomed the release of both the NHI Bill and the Medical Schemes Amendment.

“The HFA welcomes the release of Both the NHI Bill and the Medical Schemes Amendment Bill as they provide some clarity on government’s intention with regards to financing; provision; governance; and regulation of the NHI and the lead up to a sustainable model that will adequately support universal health coverage to deliver on the objectives of government.”

“HFA unequivocally supports the need for universal health coverage which is affordable and equitable and we will be formulating a submission to the Health Minister which will clearly articulate our position and make recommendations that will take into consideration the pivotal role which the private health sector can play in achieving universal health coverage,” said HFA CEO, Lerato Mosiah.

The bill also deals with the cancellation of membership and waiting periods between joining a scheme and accessing benefits. Under NHI there will be no penalty related to late joining or age. This is further to protect the interest of living spouses after the passing of the principal member or after retirement prior to payment of their benefits.

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