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Why the SA govt is incapable of running NHI
On the 8th of August the minister of health Zweli Mkhize proposed the National Health Insurance bill in the National Assembly. The bill has been of much consternation this week with health insurer Discovery seeing a knock to its share price. Joining CNBC Africa to discuss the ins and outs of the controversial bill is the Chairperson of the Portfolio Committee on Health, Dr Sibongiseni Dhlomo, Dr Johann Serfontein a Consultant at South African Private Practitioners’ Forum and Professor Alex van den Heever from Wits School of Governance.
Fri, 16 Aug 2019 11:43:49 GMT
Disclaimer: The following content is generated automatically by a GPT AI and may not be accurate. To verify the details, please watch the video
AI Generated Summary
- Concerns about the lack of a concrete costing model for the NHI and its implications for healthcare service provision
- Debate over the impact of the NHI on access to healthcare for different population segments
- Critique of the structural and financial challenges inherent in the NHI proposals and their feasibility
The proposed National Health Insurance (NHI) Bill in South Africa has sparked a heated debate, causing concern among stakeholders in the healthcare sector. On the 8th of August, the Minister of Health, Zweli Mkhize, introduced the NHI Bill in the National Assembly, triggering a wave of discontent and uncertainty in the industry. The bill's contentious provisions have resulted in repercussions such as a significant drop in the share price of health insurer Discovery on the Johannesburg Stock Exchange. To shed light on the intricacies of the controversial bill, CNBC Africa invited industry experts to discuss the various aspects that have raised skepticism and opposition. Dr. Sibongiseni Dhlomo, Chairperson of the Portfolio Committee on Health, Dr. Johann Serfontein, a Consultant at the South African Private Practitioners' Forum, and Professor Alex van den Heever from Wits School of Governance shared their insights and concerns during the interview. The key theme that emerged from the discussion was the inability of the South African government to effectively implement the NHI and address the challenges facing the healthcare sector. One of the primary points of contention raised during the interview was the lack of a concrete costing model for the NHI. Dr. Serfontein highlighted the World Health Organization's stance on the importance of cost evaluations for radical policy shifts like universal health coverage. He emphasized the need for a thorough assessment of the economic viability of the NHI, citing the 2017 report by the Davis Tax Commission, which indicated that South Africa could not afford the NHI without substantial economic growth. The absence of a comprehensive funding plan raised concerns about the potential limitations on healthcare services if the bill were to be enforced without adequate financial resources. Another key area of disagreement centered on the impact of the NHI on access to healthcare for different segments of the population. The debate highlighted contrasting views on the bill's implications for both the poor and those seeking private medical care. Dr. Serfontein expressed skepticism about the effectiveness of public consultations in addressing long-standing concerns about the NHI, citing a lack of substantial improvement in the bill over the past decade. The discussion also delved into the structural and financial challenges inherent in the NHI proposals. Professor van den Heever critiqued the government's approach to the NHI, pointing out critical flaws in the institutional and financial frameworks proposed in the bill. He emphasized the impracticality of centralizing healthcare purchasing functions and raising a tax equivalent to 3% of GDP without a feasible plan for implementation. Professor van den Heever raised serious doubts about the NHI's viability based on these technical constraints, highlighting the need for a comprehensive feasibility assessment before undertaking such a major reform. An additional point of contention revolved around the role of private medical schemes under the NHI. The interview addressed concerns raised by Adrian Gore, CEO of Discovery, regarding the detrimental impact of limiting the role of medical schemes. The discussion revealed subtle changes in the bill that could restrict the participation of private schemes and raise legal challenges related to access to healthcare and the treatment of immigrants. Dr. Serfontein emphasized the likelihood of extensive litigation and constitutional challenges to the NHI, indicating potential obstacles to the bill's implementation and long-term viability. Despite the government's efforts to promote the NHI as a solution to healthcare challenges, the interview highlighted pervasive skepticism and opposition to the bill's current form. The interviewees raised critical questions about the bill's feasibility, economic sustainability, and impact on access to healthcare for different population groups. The challenges and controversies surrounding the NHI bill underscore the need for thorough reviews, consultations, and revisions to ensure that any healthcare reforms align with the country's complex healthcare landscape and societal needs.
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