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Mediclinic News : THE THREE BIGGEST FIGHTS LOOMING FOR THE NATIONAL HEALTH INSURANCE

Title

THE THREE BIGGEST FIGHTS LOOMING FOR THE NATIONAL HEALTH INSURANCE

Date

2019-08-12

Link

https://bhekisisa.org/article/2019-08-12-the-national-health-insurance-what-it-means-and-the-fights-we-can-expect/

News Description

Medical aids as we know them will disappear by 2026 under the National Health Insurance (NHI) Bill released today. Health Minister Zweli Mkhize unveiled the Bill today in Pretoria. Under the NHI, the government will provide a package of comprehensive health services for free at private and public health facilities as part of its bid to more equitable access to quality healthcare. Medical aids will eventually be relegated to providing top-up cover under the NHI — or coverage for procedures or treatment that fall outside government’s package of care. The government will, in turn, become the single largest purchaser of health services in the country, buying them from accredited private and public facilities with a centralised NHI Fund. While comprehensive medical aids are still around, they will also be shifting to standardise a basic coverage package across the industry in line with what’s already on offer in the public sector, Mkhize revealed earlier this week at a Bhekisisa editor’s forum. “We are working with the Council for Medical Schemes to ensure that every medical scheme pays for the same package of primary health care services as that provided by the public sector”, he explained. “This is part of the process to revise the Prescribed Minimum Benefits that the council is working on.” Prescribed Minimum Benefits (PMBs) are a list of 270 conditions and specified treatments that all medical aids must cover, including emergency medical care and chronic illnesses. The changes to PMBs are one of the early signs — at least publicly — that the government is moving on recommendations made by the Competition Commission as part of its four-year investigation into the spiralling costs of private healthcare ahead of government’s plans to begin buying services from the sector. The commission found that not only were consumers paying more for less when it came to private healthcare, but that the array of packages made it impossible for people to compare offerings between schemes. Standardising a basic option ahead of the NHI will likely cut down confusion, the commission said in its preliminary report, but would not necessarily address high costs South Africa’s healthcare system remains highly unequal. When expressed as a proportion of gross domestic product, roughly the same amount of money is spent on catering for the roughly 16% of South Africans who have medical aid as the other 84% who rely on the overstretched public health system, according to a review of World Health Organisation data recently published by the Mapungubwe Institute for Strategic Reflection. The health department expects the final NHI Act to come into effect before March 2020, according to its latest annual performance plan.
Created at 2019/08/19 10:17 AM by Mediclinic
Last modified at 2019/08/19 10:17 AM by Mediclinic