Discovery Health CEO Jonathan Broomberg. Picture: SUNDAY TIMES
Discovery Health CEO Jonathan Broomberg. Picture: SUNDAY TIMES

Health Minister Aaron Motsoaledi unveiled two bills on Thursday intended to move SA towards universal access to quality healthcare — the Medical Schemes Amendment Bill and the National Health Insurance (NHI) Bill.

Proposed changes to the Medical Schemes Amendment Act include the eradication of co-payments for medical aid members when medical aids do not cover their full doctor or hospital bills.

Vaccinations‚ primary and preventative care and contraceptives have to be paid for by medical aids‚ which generally do not cover preventative healthcare. The bill also proposes the abolition of medical aid brokers.

An NHI fund would be mandatory‚ and everyone who could afford to would pay towards it. It would be like a giant state-run medical aid.

The fund would pay for all state and private healthcare in the country‚ including private specialists and hospitals.

The bills have drawn mostly cautious praise. Here is a selection of reactions.

Discovery Health

CEO Jonathan Broomberg welcomed the NHI Bill as a step in the right direction for universal healthcare, and praised the priorities it sets.

"Very appropriately‚ the NHI Fund will have an initial focus on priority projects for vulnerable groups where the need is the greatest.

"We welcome the focus on critical health priorities such as oncology and high-risk pregnancies, as well as the investment in critical preventative measures such as the school screening programme."

He said Discovery Health supported the bill’s general approach and the fact that medical aid schemes would continue to operate alongside the NHI.

"The draft Medical Schemes Amendment Bill contains numerous complex amendments to the Medical Schemes Act. We are still studying the details of the draft bill and will provide more detail on our views as soon as possible."

Board of Healthcare Funders

The Board of Healthcare Funders of Southern Africa (BHF) welcomed the proposed changes.

The BHF represents 45 medical schemes‚ administrators and managed care organisations in SA‚ and an additional 23 medical schemes across Southern Africa.

"As an industry representative body‚ we support the intention and action aimed at ensuring that the greater population of the country receives quality healthcare.

"We are committed to the NHI as a vehicle that will enable the country to achieve universal health coverage‚ not just for the 8.9-million lives covered in private healthcare but the 56-million lives of our entire [South African] population.

"We will continue to engage the minister around a practical and judicious approach to NHI and to seek guidance on where we can contribute towards enabling its success‚" BHF Southern Africa chairperson Dr Ali Hamdulay said.

Hamdulay said it was "imperative" that the private sector work closely with the Department of Health, "and share their views‚ insights and knowledge to positively shape the healthcare landscape. It’s now time for action and close collaboration."

The Public Servants Association

The PSA welcomed "with caution" aspects of the two bills.

Ivan Fredericks, its general manager, said: "The abolishment of medical co-payments is especially welcomed as relief for workers who struggle with monthly medical aid scheme contributions."

However‚ the PSA‚ which represents more than 240‚000 public sector employees‚ cautioned that the amendments should ensure that medical aid schemes and service providers do not have flexibility to simply adjust premiums and fees to recover costs.

The Government Employees Medical Scheme

The Government Employees Medical Scheme (Gems) has welcomed the publication of the bills.

Dr Guni Goolab‚ principal officer of the scheme‚ said the bills had come at just the right time‚ before a much-awaited provisional report that looked at costs in the health sector that will be released at the end of the month.

Goolab said it was good that the bills were released together by Motsoaledi.

“The NHI indicates the long-term future of the country in terms of healthcare but simultaneously with the publication of the Medical Schemes Amendment Bill‚ it confirms that there continues to be a role for medical schemes as we move towards universal healthcare‚” said Goolab.

He also welcomed the focus on the main areas that both schemes and members complained about.

“A number of the amendments speak to challenges that both members and the medical schemes have been experiencing up until now.… All of them have been raising concerns about contributions increasing above inflation and also exposure to co-payment. The amendments speak to these concerns.