Ramaphosa steamrolls ahead with the NHI despite the multitude of red flags

[Nat Quinn]

President Cyril Ramaphosa says that the government will push ahead with National Health Insurance (NHI), despite wide rejection from industry players of the coming laws in their current form.

Addressing the National Assembly on Wednesday (31 May) the president said that the government has made progress in preparation for the implementation of the NHI.

Ramaphosa reiterated that the achievement of affordable universal health care is vital for improving human health, reducing inequality and enabling South Africans to live more productive lives.

He said a major milestone towards this goal has been achieved with the adoption of the National Health Insurance Bill by the Portfolio Committee on Health, which will soon be debated in the National Assembly.

“Progress is being made in preparation for the implementation of the NHI, including interventions to improve the quality of public and private health care and the roll-out of the electronic patient registration system across public health facilities.

“The implementation of the NHI will be a momentous step towards achieving universal health coverage and creating a society built on justice, fairness, and social solidarity. Let us embrace this opportunity to create a healthier, more equitable future for all South Africans,” he said.

“As the NHI Bill is finalised through the legislative process and as it is implemented, we are determined to ensure that it both fulfils its goal of universal access to quality health care and builds on the significant capabilities of the public and private health sectors.

“We are determined that the implementation of the NHI effectively tackles inequality in health care in a sustainable manner,” he said.

Rejection

While the president talks up the government’s plan for universal healthcare, the South African Medical Association has rejected the coming laws as they currently stand.

The association this week noted that the NHI Bill remains at the centre of debates and concerns raised by all healthcare stakeholders – and it has been stated many times that the implementation of the NHI Fund alone is insufficient to embody the principle of universal health coverage as enshrined in the South African Constitution.

“While SAMA supports the principle of UHC, it does not support the Bill in its current form,” it said.

The association didn’t give a detailed critique of the laws, but noted that general comments, based on engagements around the bill, were not positive.

Specifically, the group said that the bill – which was rubber-stamped through the portfolio committee by the governing ANC majority –  was developed with disregard to the legitimate concerns and recommendations of experts – particularly on critical issues such as the introduction of Contracting Units for Primary Healthcare, Benefit Packages and Reimbursement Models, amongst others.

“Accordingly, there are significant concerns with regard to the provision of healthcare services to patients in the country should the bill be taken forward,” it said.

This echoes many criticisms levelled against the bill, which have argued that provisions are vague – particularly around funding – and that not enough modelling and testing has been done to see if the country is even equipped to implement it.

Red flags

Notwithstanding provisions in the bill which have already been declared unconstitutional, warnings from parliament’s own legal teams have already stated that parts of the bill will open up the government to legal challenges on constitutional grounds.

SAMA added that trust in the government’s capability to manage the over R500 billion budget efficiently is severely eroded – especially given how Covid-19 funds were mismanagement, among various other corruption scandals.

“Misappropriation of funds in various state-owned entities casts doubt on the government’s ability to handle the healthcare budget responsibly. The public, alongside healthcare stakeholders, cannot simply entrust their lives to a government with an established history of financial mismanagement,” it said.

SAMA said that while universal healthcare, as envisaged in the objectives of the bill, intends to improve the health and livelihoods of the citizens of South Africa, the NHI Bill, in its current form, sets up the healthcare system for failure at the expense of further deterioration of the health and wellbeing of all who live in the country.

“SAMA believes that a robust approach to health systems strengthening is indispensable, as it would rectify the current deficiencies and overcome the challenges posed by the NHI. This approach seeks to enhance the efficiency, effectiveness, and resilience of the healthcare system, ensuring the delivery of optimal care to all individuals.

“Governance within the healthcare sector must be strengthened, with transparency and accountability at its core. Effective management of funds and meticulous budget allocation is imperative to rebuild trust and demonstrate responsible stewardship of public resources,” it said.

 

source:Ramaphosa steamrolls ahead with the NHI despite the multitude of red flags (businesstech.co.za)

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