Zohra Mohamed Teke
COMPREHENSIVE details on the impact of the government’s proposed National Health Insurance (NHI) have begun to emerge for the first time, following a consultative KZN Health summit held in Durban at the weekend.
Addressing more than 800 delegates at the summit, KZN Health Department head Sibongile Zungu said the department would fast-track its overhaul of health services in the province in preparation for the NHI.
“We are strengthening our cost-cutting measures including eliminating fraud and corruption within our ranks, filling and retaining staff and re-aligning our resources so that they can be used efficiently and effectively,” he said.
“People do not ask for much – they want a clean facility, efficient health care and don’t want to be charged an arm and a leg to get this – that’s where our public health sector is heading, but we need to understand that it is a process,” said Zungu.
One of the key revelations of the NHI which has not emerged previously is that patients can continue to have access to their regular doctors in the private sector under the plan – provided that the practitioner is contracted into the NHI.
“Contrary to misconceptions that people can only go to a state hospital under the NHI, you can still choose to go to a private doctor and the state will pay for this – provided that the doctor is a member of the NHI,” said Dr Anban Pillay, director of National Health’s financial and health economics cluster.
“For this to happen, he or she will have to pass a quality standards assessment which will be monitored by the office of Standards Compliance. They will have to agree to performance requirements in terms of their curative rates, for example, and finally they would have to agree to NHI reimbursement rates which will be close to the current figures, making it both cost-effective for the state but at the same time lucrative for private medical practitioners.”
The financial cost of the NHI has been hotly contested.
However, Pillay dismissed criticisms of the NHI as “misinformation”.
“The fact of the matter is that the NHI will cost around R255 billion when it is fully implemented in 2025. Government’s spending on health, even without an NHI costing, will be R205 billion by then.
Speakers at the summit all echoed similar views that costs of the NHI would not be astronomical, and lashed out at critics who claimed the NHI was unaffordable. Chair of the ministerial advisory committee on the NHI Dr Olive Shisana said innovative funding was being looked at to finance the gap in NHI costs.
The declarations at the end of the summit resolved to work towards removing obstacles to the NHI, including addressing staff shortages, a radical change in the management of health services and a mass mobilisation campaign to engage all stakeholders on how the NHI will work.