LETTER: NHI unlikely to come to fruition without a technical assessment
SA’s medical schemes are prohibitively expensive, suitable only for high-income countries with low levels of unemployment, writes Michael Settas
Finance Minister Pravin Gordhan announced in his budget speech that the contentious National Health Insurance (NHI) fund is to be established this tax year, with an initial injection of R5bn. Besides the legal and political hurdles the NHI faces in coming to fruition, it is entirely imprudent to even contemplate this gargantuan project without first undertaking an exhaustive technical assessment. There are four basic pillars to any healthcare system: how much it costs; who is going to pay; what the benefits are; and who is going to deliver them. The white paper released in December 2015 contained precious little detail on these aspects, other than it will be expected of taxpayers to do the paying part. The 10 NHI pilot sites operating since 2011 have been unable to contract even one-fifth of the providers needed to operate effectively. The reason? The tendered reimbursement rates were so low that private sector doctors considered them derisory! Yet Treasury’s chief director for heal...
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