The National Health Insurance Bill IV: Summary of the HSF’s conclusions on the Bill
21 January 2020
OUR CONCLUSIONS
1. While we support the underlying concept of universal health care, we believe that insufficient information has been provided to enable a lawful public consultation. In addition, grossly inadequate research, planning and analysis, concerning the operational, administrative and financial aspects of the NHI, have led to a Bill which cannot be considered to be the product of a rational process. National Treasury’s opinion that it cannot be funded as envisaged, provides further concrete evidence of an exercise which is glaringly irrational.
2. Government has been unable to manage the public health sector in an acceptable manner and, at the same time, has also shown itself to be unable to regulate the private health sector. In addition, it has shown itself to be incapable of managing many State entities in a satisfactory manner. Government now proposes to establish an NHI which will control and manage most of the health sector, and which is intended to serve as the single purchaser and single payer of health care services from both the public and private sectors. It makes no sense to try to integrate these two segments of the national health system into one consolidated purchasing framework, if there is no clear plan to address their respective shortcomings.
3. Government has not explained how the NHI will ensure health services of an acceptable quality. It has not completed a feasibility study for this massive enterprise and is unable to provide an estimate as to what it will cost. It is therefore impossible to estimate the increase in tax that is required to fund it and the Bill and the accompanying memorandum do not provide adequate detail as to how Government proposes to implement, fund and run the NHI in an efficient manner.