South Africa’s National Health Insurance (NHI) Bill

16 June 2023

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Source: Iress

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South Africa’s National Health Insurance (NHI) Bill

What does the NHI propose?

The National Health Insurance (NHI) Bill was recently passed by Parliament, with the aim of providing universal health insurance to all individuals in South Africa. The bill proposes pooling the resources of all citizens in the country to achieve this goal. However, it should be noted that the Bill still requires approval from the National Council of Provinces and subsequent signing by the President before it can be enacted. According to the government, the bill intends to ensure that every citizen has access to high-quality healthcare, regardless of their income or health condition. Under the proposed system, the government will take charge of purchasing all necessary health services for the population. This includes determining the types of services available, the placement of health facilities, and the allocation of health professionals.

Funding

The specific details of the funding structure for the NHI initiative are currently uncertain. However, it is suggested that the funding will rely on the existing tax plan, with additional taxes or rates imposed on those who have the financial capacity to afford them. It is important to note that South Africa currently faces one of the highest unemployment rates globally, resulting in a relatively small tax base. The implementation of the bill in its entirety could potentially place a substantial burden on taxpayers, further straining the already challenging economic landscape.

What does this mean for SA Health Insurers?

Health insurers in South Africa, such as Discovery, Momentum and many others, currently serve around 9 million individuals. However, under the NHI bill, these insurance schemes will only be allowed to provide coverage for procedures that are not included in the bill. This could potentially render them obsolete or significantly reduce their scope of services. The complete implementation of the NHI bill is estimated to take approximately 10 to 15 years if everything goes according to plan. Nevertheless, it is important to note that there is a possibility of legal challenges being raised against the bill, which could potentially impact its timeline and implementation.

The NHI bill raises numerous unanswered questions regarding coverage, funding, impact on current medical aid schemes, implementation timeline, legal validity, and unintended consequences. Only time will reveal the true outcomes and effects of the bill as it progresses and more details emerge.