Health Minister Dr Joe Phaahla says the government plans to implement National Health Insurance (NHI) incrementally and gradually phase out the role medical schemes play in funding private healthcare services, according to reports by Business Day and Fin24.
“NHI is not going to be something that happens at a go, at full blast,” Business Day quoted the minister as saying during a virtual event hosted by Momentum Health Solutions this week. “Medical schemes will continue to cover those aspects that NHI is not covering at the introductory level,” he said.
According to Fin24, NHI will be introduced at the primary healthcare level.
“The introductory level of the NHI will focus on the primary health sites, the preventative and early detection of diseases, early treatment and GPs, but exclude your secondary and tertiary services,” Dr Phaahla was quoted as saying.
In the early phase, everyone – whether or not they belong to a medical scheme – will get their primary healthcare services via the NHI, Dr Phaahla said. The NHI will pay contracted GPs, and South Africans will also get basic treatment from public clinics, Fin24 reported.
“What is envisioned is that, at that stage, the medical schemes will then reduce their funding at the primary health area, which will then be ceded to the NHI. The NHI then will cover the entire population in terms of primary health services, [such as] basic dentistry, family physicians, and so on,” Dr Phaahla said.
At that stage, medical schemes will provide cover for members who want to see a specialist or have to go to hospital.
But as the NHI fund progresses to cover secondary and tertiary healthcare services, private medical insurance will focus only on services not included in the NHI basket of care, Fin24 reported.
Parliament’s Portfolio Committee on Health is currently deliberating, clause by clause, on the NHI Bill.
According to Business Day, Momentum Health Solutions chief marketing officer Damian McHugh said there appears to have been a welcome shift in the government’s view on how to implement NHI, away from a big-bang approach. It could take years, perhaps as long as a decade, for NHI to complete the implementation of primary healthcare cover.
“I was very encouraged [by the minister’s remarks]. I think many of us had thought the industry would be gone in two to three years,” McHugh was quoted as saying.
