It’s time for SA to embrace a new healthcare model
The NHI is not a move to dismantle the commercial sector, it’s a call to action for much-needed reforms
The National Health Insurance (NHI) is not a radical shift to dismantle a functioning system, but an opportunity to review two poorly functioning ones. The public sector sees very high volumes of patients but gives them bad service and produces very poor outcomes. The private sector is modeled on low-volume, high-cost care — it uses its huge quantities of resources badly, to service very few people. As the health market inquiry report makes clear, the large, commercial medical schemes are resisting needed reforms which, with better productivity, would lead to the convergence of the two systems. In particular, they persist with an outdated tariff system that pays for services, not outcomes, and doesn’t support team-based delivery models. This is probably because it threatens their claim payment and “managed care” models that justify a very high income. This strategy is counterproductive for their members.
SA cannot move forward socially or economically without convergence. We n...