Ryan Noach from Discovery Health has revealed that the single-funder model described in the National Health Insurance (NHI) Bill would not be able to achieve the government’s goal of equitable access to healthcare.
Revealing that Discovery Health does not endorse the single-funder model proposed in the NHI Bill, he said this approach is not only risky and inefficient, but it is also unlikely to be equitable since cross-subsidies cannot be properly managed.
The passing of the NHI Bill will have no immediate impact on medical schemes, however, Section 33 sets out that once the NHI is fully implemented (with no clear definition of what this means), medical schemes would not be allowed to provide cover for anything that the NHI covers. “In other words, at the discretion of the minister, when the NHI is fully implemented – the schemes would only be allowed to offer what the NHI does not offer.” – he added.
Due to this, the NHI would be a single monopolistic funder for the NHI package of services. Noach said that even though this may be some way off, given that Department of Health officials have said it may take a decade for NHI to be fully implemented, this provision drives away investment in the health sector and the opportunity to encourage the development of innovative healthcare delivery models for all South Africans. Alternatively, he recommends a multi-fund framework, which he explains as “not only less risky and faster to implement, but also ensures that cross-subsidies are managed to ensure that social solidarity is achieved.
Noach is a believer in financial integrity and sustainability being the only be achieved through collaborative work between the private and public sectors. He also mentioned that Discovery had made comprehensive recommendations to Parliament explaining how a multi-funder approach can speed up the implementation of NHI for the benefit of all South Africans.
Everything that Noach spoke on, echoes the sentiments of Busi Mavuso, CEO of Business Leadership South Africa. Mavuso said NHI, as envisaged in the Bill, would leave all South Africans worse off. So she recommended that the system should instead consist of a private-public partnership. According to her, the NHI Bill illustrates that the government did not learn from other successful public-private partnerships.
“With the right incentives, the private sector can complement government efforts, speed up the investment needed and reduce costs to the state and users.” – she added.
Mavuso said together we can build a mechanism that delivers the best possible universal healthcare to South Africans at the lowest cost while ensuring we do not destroy the parts of our health system that do work effectively.
Moreover, forcing the private sector out of healthcare provision could discourage internationally mobile businesspeople from working in South Africa.