NHI threatens to collapse health insurance in South Africa – Netcare

In its current form, the government’s NHI Bill threatens to collapse the health insurance industry in South Africa, which employs thousands of people and adds billions of rands in value to the economy. 

This is feedback from one of South Africa’s largest private hospitals, Netcare, whose chairman said in its annual report that it is committed to creating a sensible, constructive, and evidence-based National Health Insurance. 

However, the government’s proposed NHI Bill is far from that, Netcare chairman Mark Bower said in his board chair’s review. 

“The NHI Bill in its current form poses serious challenges of practicality and affordability,” Bower said. 

It also lacks clarity on critical issues such as what will be covered by the NHI and what won’t, how it will be financed, and how much it will cost. 

“We are particularly concerned about specific provisions in the Bill that prevent medical aid schemes from funding services provided by the NHI,” Bower said. 

“In effect, these provisions take money out of the national health system and pose the real threat of collapsing the health insurance industry in SA.” 

Bower said that international experience has shown that single-payer healthcare systems, funded by taxation, do not expand access to quality healthcare. 

“A multi-payer model would ensure that after paying mandatory NHI tax, those with the means could still fund healthcare privately if they wish, relieving public money to be dedicated to the most vulnerable.”

He added that it is clear that a sustainable healthcare system that provides quality care to all needs strong public and private sector collaboration. 

To this end, Netcare has made comprehensive submissions to the National Council of Provinces and the National Assembly on proposed amendments to the NHI Bill. 

However, the Bill was passed by both chambers of Parliament without any consideration of the proposed amendments. 

Through Business Unity South Africa and Business for South Africa, Netcare submitted a formal petition to President Ramaphosa asking him to send the Bill back to Parliament for revision. 

“The petition expresses our collective belief that the Bill in its current form is not only unworkable and unaffordable, but also unconstitutional on substantive and procedural grounds,” Bower said. 

Netcare said it stands ready to engage constructively with the government on various ways of ensuring universal access to quality healthcare in a sustainable way.