The National Health Insurance (NHI) Bill, recently signed into law by President Cyril Ramaphosa, aims to transform South Africa’s healthcare system by providing universal health coverage and addressing socio-economic imbalances. Industry leaders express diverse perspectives on the bill’s implications, highlighting its potential to reshape healthcare access and the significant challenges in its implementation. The bill envisions a phased rollout, with the private sector playing a complementary role. Clarity on funding, operational models, and collaboration between public and private sectors remains crucial for its success.
BONITAS Update on NHI Signing
Dear M. Makridou
As you may have heard, President Cyril Ramaphosa will publicly sign the National Health Insurance (NHI) Bill into law on Wednesday, 15 May 2024. This legislation aims to transform South Africa’s healthcare system to achieve universal health coverage and address socio-economic imbalances. However, the Act is still a long way from being fully implemented.
What is NHI?
NHI (National Health Insurance) is a health financing system that is designed to pool funds to provide access to personal health services for all South Africans based on their health needs, irrespective of their socio-economic status and is not like a medical scheme.
Your membership remains unaffected
We understand that you may have concerns about how this new law might impact your medical scheme membership. Please be assured that there is no need to panic. Your Bonitas membership remains unaffected, and we are dedicated to maintaining our members’ access to affordable, quality health services as usual.
Implications of Section 33 of the Act
As the NHI Bill rolls out in phases, it is important to note that Section 33 of the Act envisions a future where the role of medical schemes is reduced to providing complementary cover. However, we want to reassure you that we will continue to actively pursue all avenues to address the unanswered questions and practical implications of the Bill in your best interest.
We want to assure you that we will continue to deliver our services, as experienced over the last 40 plus years.
Kind regards
Bonitas Medical Fund
BESTMED’S Position on National Health Insurance (NHI)
As part of South Africa’s health eco-system, Bestmed strives to provide access to quality healthcare. As a result, we will continue to play a key role in expanding health services to South Africans across the country, not only through our Scheme, but also through our community outreach initiatives and extended partnerships. We recognise, and fully support, the importance of adopting Universal Healthcare principles and believe that all medical schemes have a fundamental role in what is clearly a critical national imperative.
The South African healthcare system faces many serious challenges and reform is needed. It is against this that clarity regarding the funding, operational model, implementation plan and the role of the private healthcare sector remains important in order to resolve the uncertainties and concerns around the viability of the NHI. This is despite the bill having been signed into law on Wednesday, 15 May 2024.
We fully believe that the public and private healthcare sectors can work together in providing quality healthcare to the citizenry. We are, therefore, committed to continuous engagement and partnership with government to collaboratively find a path that allows Schemes to continue to fulfillfulfil a meaningful role in the healthcare value chain, but also contribute to enabling access to high-quality healthcare into the future. Focus is very much on government and National Treasury to provide clarity and certainty regarding aspects which remain a source of much speculation. These include but are not limited to funding mechanisms, implementation plan as well as the role of the private sector.
Personally Yours,
Zerina Richards
Advisor Sales Channel Manager
MEDIHELP Update on the NHI signing
Dear Adviser
As you know, President Cyril Ramaphosa will sign the National Health Insurance (NHI) Bill into law tomorrow. We have an understanding of the implementation of similar legislation around the world and it is clear that enacting such legislation takes on average 15 years and even longer as it is a complex process.
Understanding the complexity and the time required to implement such comprehensive legislation, we anticipate that the full enactment of the NHI will be a gradual process, potentially extending over 15 years or more. This is consistent with global trends and experiences with similar healthcare reforms.
The successful implementation of the NHI will largely depend on several critical factors, including the preparedness of our current healthcare infrastructure, the availability and training of healthcare professionals, widespread public education and engagement, the prevailing political climate, and the allocation of adequate financial resources.
Please be assured that we are closely monitoring the developments surrounding the NHI. Our commitment to providing you with the latest information remains steadfast. For the foreseeable future, we foresee no immediate impact on your clients’ medical aid cover. We do however understand that these developments may raise concern among your clients and have sent them the communication attached hereto.
You can also read and share our media statement with your clients who may have concerns.
Kind regards
Your Adviser Support team
National Health Insurance: Frequently Asked Questions
What is the National Health Insurance?
National Health Insurance (NHI) is a health financing system that is designed to pool funds together to provide access to quality and affordable personal health services to all South Africans based on their health needs, irrespective of their socio-economic status. The intention of the Fund is that it aims to pay for healthcare for all South Africans.
Who will be covered by NHI?
Every South African permanent resident, refugee, inmate and specific categories of foreign nationals will be able to register for NHI. All children born and living in South Africa will qualify for NHI. Everyone else will qualify for treatment for emergencies and diseases that can cause outbreaks. Visiting foreign nationals will be covered by their mandatory travel insurance.
What does the NHI benefit service package look like?
There are still questions surrounding what the services benefits package is likely to be. At this stage, there is no clarity of what the service package will look like.
How does NHI work?
The NHI will buy quality healthcare services on behalf of the people of South Africa. The NHI Fund will enter into contracts on a voluntarily basis with private health providers. It will not be compulsory for the providers to belong to the Fund.
Will all services be covered by NHI?
Whilst NHI aims to provide services, through information available in the public domain the NHI Fund will not cover all services. This means that for the services not covered by the NHI Fund, the citizens will have to cover those from out of pocket.
What happens if my doctor or hospital is not contracted to the NHI Fund?
This means that you will have to pay cash or out of pocket should you obtain service from these providers, and you may not claim from the NHI Fund for reimbursement purposes
Will I have to pay more tax for NHI?
Although the government indicated that initially there will be no tax for the NHI, this is contrary to Treasury’s view that there is no funding plan as yet, given the country’s constrained fiscal position, low economic growth and narrow tax base. It is estimated that to implement, NHI would cost well in excess of R200 billion a year – with some estimates as high as R1 trillion a Year.
What does enactment (signing by President) mean?
Enactment refers to the passing of a law and is a crucial step in law making. A Bill, which is a draft law, is only considered law when signed by the president after being considered and approved by both Houses of Parliament, the National Assembly and the National Council of Provinces.
Are there any immediate (even unintended) consequences for our client schemes?
There are no immediate consequences for members as the implementation of the law is a process that will take time. There are many structures that need to be put in place to effect this law, starting from the financing, public health system redesign, defining of benefits under NHI, negotiations with health care providers, etc.
What is the likely timeline for full implementation (the point at which medical aid schemes may only fund supplementary care)?
At this stage it is believed it will be a few years or even decades before we start to see full implementation and even when it starts, we anticipate a phased approach. In real terms, more clarity will need to be provided by the Department of Health.
Is it ‘business as usual’ for AfroCentric?
Yes, it is. We should continue to reassure our members and providers of the same quality care and service they always have received.
