South Africa

NHI will take over a decade to implement

South Africans should not panic about the implementation of the National Health Insurance (NHI) scheme as it will take over a decade to roll out – if it is ever fully implemented. 

This is feedback from Bankmed CEO Teddy Mosomothane, who urged clients in an email not to panic over the signing of the NHI into law. 

Mosomothane outlined several reasons why South Africans should not panic about the NHI, explaining why it is unlikely to affect medical aid providers for years to come. 

Chief among these reasons is the likelihood the NHI Act will be challenged in court, with Bankmed saying it will take the government on through the Health Funders Association. 

Mosomothane’s reasons not to worry about the NHI are listed below –

  • As already indicated above, the NHI Act, in its current form, will be legally challenged;
  • It will take a very long time (and estimates suggest 10 to 15 years) before NHI is “fully implemented”.The NHI Act suggests that is the point at which medical schemes will not be able to provide cover for services that are paid for by NHI;
  • The unfortunate financial constraints that our country faces currently make it impossible for the implementation of NHI to present any threat to the continued existence of medical schemes for the foreseeable future;
  • Even when NHI is fully implemented based on the NHI Act as it is now, medical schemes will be allowed to exist but confined to what is not covered by NHI. It is currently not clear what will be covered by NHI, but the financial constraints referred to above, and the implications of such NHI cover having to be available for the whole population in the country, leaves substantial room for the role of medical schemes; 
  • Even the Minister of Health himself, Dr Joe Phaahla, at the signing of the Bill ceremony, is quoted as saying, “Please don’t cancel your medical aid”.

“We cannot overemphasise our advice to you to NOT panic. This important matter is receiving the required attention,” Mosomothane said. 

“We reiterate our assurance that staying close to this matter is important to us and that our efforts are strongly informed by your interests specifically and the interests of South Africans in general.”

Bankmed CEO Teddy Mosomothane

ANC government cannot implement the NHI

Professor Alex van den Heever of the University of the Witwatersrand has previously said that the government’s NHI scheme l will take 1,000 years to implement as it is “far too complex for this government ever to achieve”. 

He said that the proposals contained in the Bill are financially and institutionally impractical. 

The government aims to consolidate the public and private healthcare systems into a single system that does not yet exist. 

This consolidation is to be done by a department and a government that cannot run state institutions effectively, according to Van der Heever. 

He said it is “far too complex for this government to achieve”.  The only reason why Parliament passed the Bill is to give the impression that the government is doing something. 

In reality, the Bill is “merely window-dressing health reform and is not substantive”, Van den Heever said. The can will just be kicked down the road, and “nothing of substance will happen”. 

NHI in South Africa has become a political tool for the ruling African National Congress (ANC) to score political points and is “not a true, public interest-oriented health reform”. 

Van den Heever said the government has failed to address any of the problems faced by the existing public healthcare system and should first start there.

South Africa’s public healthcare system has the potential to be highly functional and is on par with the best systems in the world on paper. 

In reality, the government has failed to make high-quality healthcare a reality for most citizens.


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