The much-maligned National Health Insurance (NHI) bill has been tabled for Parliament’s consideration. Plans to prevent its rollout are already well underway, as medical professionals and opposition political parties vehemently oppose the proposals.
NHI in brief
- Opponents believe that NHI would essentially be another state-owned entity – potentially failing, like Eskom, Denel and SAA
- The taxpayer will fund the NHI
- General tax revenue will include transferring funds from provincial health budgets to the NHI Fund
- Taxpayers’ medical scheme fees tax credit will be reallocated to the NHI Fund
- A payroll tax (employer and employee) will be implemented
- A surcharge on personal income tax will be implemented
- The bill obscures what the NHI rollout would cost, but three figures include R165 billion, R259 billion and R450 billion
- There are roughly 21 million taxpayers in South Africa
- Only 30% of them – about 7.6 million people – are actually registered to pay tax or sit above the annual income threshold
- Taxpayers would pay between R7 857 and R21 428 per person for NHI
- If everyone in South Africa had to contribute, they would pay between R2 807 and R7 656 per person
The ANC government wants to “ban” medical aids in its current format when its planned National Health Insurance (NHI) service kicks in.
This is according to a Rapport article, citing a leaked letter which the Treasury wrote to Olive Shishana, head of the government’s NHI war room.
This, the newspaper said, is a turnaround from the National Health Insurance Bill which was released for public comment in July – which stated that medical aids would continue to operate as normal.
The new version of the NHI Bill, which according to the leaked letter was already sent to cabinet for approval, does not support medical aids in their current format.
Rapport said the new version contains a clause which prevents medical aids or any other voluntary private health insurance scheme covering anything which is offered through the NHI.
This is to make sure the NHI “achieves its objectives” and will “eliminate the fragmentation of health care funding”.
NHI shenanigans exposed
Spotlight, which is published by Section27 and the Treatment Action Campaign, said the NHI Bill has been changed without consultation and agreed upon changes were not implemented.
Spotlight said Shisana and Minister of Health Aaron Motsoaledi have sidelined Department of Health and Treasury officials in preparing a new version of the bill for submission to Cabinet.
“The Treasury letter highlights an amended provision stating that the role of medical schemes will only be complementary to the fund,” Spotlight said.
“Medical schemes will thus not be allowed to offer services already offered through NHI”.
According to the Treasury letter, such a provision is “highly premature given that it will take years for the fund to be meaningfully offering services equivalent to those existing 8.8 million current medical scheme users access from the private sector”.
“This section is unnecessary at this point and will be perceived as extremely threatening to existing medical scheme users and tax payers, to the entire private health sector, and will undermine investment.”
“This section will almost certainly bog the bill down in endless legal challenges and should be deleted,” the Treasury letter states.