From FM:

National health insurance


By Claire Bisseker

But the industry is sceptical as to whether plan will be realised

In five years, SA's health-care system could be unrecognisable. The Committee of Inquiry into a Social Security System has a long-term vision for the system, which differs radically from what we have now.

Everyone, except the poor, will contribute to a National Health Insurance (NHI) fund through earmarked taxation to ensure each person has access to basic health care.

However, private care will continue to exist alongside public health services and people will be able to pay a top-up fee over and above their NHI contribution to purchase private care.

"It's comforting that the plan acknowledges that there will be a private health-care sector as well as a public sector and the two should work together," says Discovery Health principal officer Shaun Matisonn. "This should silence the conspiracy theorists who've maintained that government's covert agenda is to nationalise private health care."

The plan guarantees the long-term existence of medical schemes by recommending that by 2005 medical aid membership be compulsory for all middle- and high-income earners.

But, given that the cost of medical aid has exceeded salary inflation for much of the 1990s and employers are reducing their exposure to these costs, compulsory scheme membership is bound to be resisted.

The plan's architect, health economist Alex van der Heever, doesn't believe that this proposal will worsen unemployment by increasing the cost of labour. He says 70%-80% of this population already belong to medical aids and only large employers will be targeted. Also, he believes that medical aid will be cheaper because of the preceding reforms spelt out in the plan.

The plan proposes that change be achieved gradually in four phases. But its critics say not enough time is allowed to lay the basic foundational reforms.

In phase one, the main reforms involve containing costs in the private sector and raising the quality of public hospitals. Only a year is allowed for the latter, something which many commentators regard as unfeasible.

The key reforms are the creation of a compulsory medical scheme for the 1m civil servants and a voluntary state-sponsored scheme targeted at the emerging market. The latter will offer a low-cost package of comprehensive services delivered mainly through the public health facilities but also through cost-efficient private providers.

The rationale is that since the private sector has failed to develop affordable products for this market, the state is obliged to step in.

The idea is that with the state assuming the position of market-maker and going after the emerging market, private medical schemes will be obliged to defend their turf by launching cost- competitive products, says Praxis Capital director Jonathan Broomberg. The state will use its purchasing power to wring volume-based discounts and risk-sharing deals out of private health-care providers.

Other reforms will focus on improving public hospital management, improving the quality of care and making it easier for public hospitals to contract with medical schemes.

It makes sense on paper, but most private providers scoff at the suggestion that the public sector can be sufficiently upgraded to cater for this new market.

Netcare executive director Norman Weltman says the public hospital sector lacks the surplus bed capacity and clinical staff to accommodate an increase in patients. Then there's Aids, which is manifest mostly in the emerging market and is swamping general wards.

The medical aid industry body, the Board of Healthcare Funders (BHF), says that before the plan is adopted there should be a comprehensive study into the effect diseases such as HIV/Aids, TB and malaria will have on the funding environment, both private and public.

Given the regulatory authority's poor track record in using regulatory reform to try to control medical inflation, most private providers are sceptical that the proposed changes will actually succeed in bringing down the cost of medical aid.


And a quote from M&G forum

The ANC and their crooked (in so many ways) idea could't run a tuckshop, let alone a hospital. Now you want them to run NHI.

PS As a general rule if Lyin' Jess Duarte speaks up on anything, the truth lies somewhere else. As usual she mixes issues, confuses them further, and then churns out lies.

Run people, run.

On the bright side, apparently it will be about 5 years before such a scheme can be implemented, assuming that the ANC incompetents can take their hands out of their pockets long enough to actually do the spadework to actually bring in such a system. Then the legal cases will take another 3 years, minimum.

Any by that time, the ANC will have been booted out on their sorry arses, the current opposition parties will have sorted themselves get the picture? Or, in language that Siphiwo Siphiwo and his band of ANC apologists can understand.....
Jesus is coming real soon!
Very naïve…

Anyway, more TAX anyone? Once again 14% of the population’s money used to raise the standards of living for 86%, while being dragged under in the process…

One just has to do the math to realize what a giant failure this will be, and ill bargain that the Governments Health spending will plummet if this gets implemented, so in short more money stolen from us = more Beemers, Merc’s and million rand party’s for the bureaucracy.