Treasury and health may appear to be singing from different hymn sheets when it comes to National Health Insurance (NHI) — but behind the scenes officials are quietly crafting a pilot structure to test crucial aspects of government’s grand plan for universal health care. This interim entity will purchase a limited set of services from public and private sector alike, possibly as early as next year, while the legal framework required to breathe life into the NHI is being finalised. The NHI is, at core, a set of financing reforms that promise health care that is free for everyone at the point of service. On that much, everyone in government agrees. But how this will be achieved, at what pace, and where the private health-care sector fits in, remains deeply ambiguous. On the other hand, former finance minister Pravin Gordhan and incumbent Malusi Gigaba have articulated a more progressive approach, suggesting that "small adjustments" be made to the medical tax credits. These are typical...

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