Home South African National Health Insurance Bill set for heated debate

National Health Insurance Bill set for heated debate

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The Portfolio Committee on Health has adopted its 75-page report on the National Health Insurance Bill, which will be debated in the National Assembly, but there is some opposition to the bill.

THE PORTFOLIO Committee on Health has adopted its 75-page report on the National Health Insurance Bill, which will be debated in the National Assembly, but there is some opposition to the bill.

Parliament says that this bill creates mechanisms for the equitable, effective and efficient utilisation of the fund’s resources to meet the health needs of users.

“It also seeks to create mechanisms to preclude or limit undesirable, unethical and unlawful practices in relation to the fund. In facilitating effective public participation on the bill, the committee conducted nationwide, in-person public hearings in all nine provinces from October 2019 to February 2020. Additionally, the committee conducted virtual public hearings from May 2021 to February 2022,” said Parliament.

Meanwhile, the Hospital Association of South Africa says that they believe that approving the bill without substantive consideration of the many valid and significant recommendations and contributions made by many participants during the Parliamentary hearing was deeply regrettable and a missed opportunity by the committee.

“As the hearings demonstrated, there is broad support for universal access to quality health care. There is a willingness to engage with the government to collectively craft the best possible legislation. To summarily ignore the many who voiced their concerns regarding governance structures and operational efficiency concerns, the concentration of risk in a single-payer system in an unstable economy featuring endemic corruption, and the many other concerns raised by its own attorneys, is short-sighted and highly unwise,” said the association.

The association said that passing such vast, complicated, risky and consequential legislation required confidence, trust and collaboration among all stakeholders. The approach taken undermined confidence and posed a threat to trust.

“We urge the National Assembly and the National Council of Provinces in their deliberations on the bill to insist on a multi-payer model to mitigate against the concentration of risk, an iterative roll-out based on milestones rather than dates, and to pay heed to the nation’s concerns that the proposed National Health Insurance Fund is susceptible to theft and corruption by proposing and approving alternate and appropriate governance structures.

The health-care reform decisions taken now would affect the sustainability of South Africa’s health system and would be deeply felt for generations to come,” said the Association.

The Health Funders Association (HFA) has also said they reject the National Health Insurance (NHI) Bill in its current form as it perpetuates several tenets that the HFA believes will undermine the quality of health care and the objective of moving towards universal health coverage in South Africa.

“While this version of the bill includes some minor amendments, these amendments fall short of the extensive recommendations made by the private health sector (including the Health Funders Association), opposition parties, various experts, and other role-players, as well as the concerns raised by the Parliamentary Legal Adviser,” said the HFA.

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