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TIMES SELECT What will it cover, at what price? Unanswered questions will mean endless court action if sense doesn’t prevail The national health department is rushing through the appointment of members to an interim steering committee to slug out the details of the National Health Insurance (NHI) bill. This comes as law experts warn of court action against NHI if “level heads” do not prevail. At a round-table discussion on Wednesday evening, the key points of concern remained the lack of details in the bill on what benefits will and will not be covered, and what it will cost. On Friday, a letter signed by the deputy director of the health department, Yogan Pillay, was released asking for nominations for the steering committee of the national benefits committee. The nominations have to be made by Tuesday. The rush to appoint an interim steering committee comes as the Helen Suzman Foundation requested more time from the NHI health parliamentary portfolio committee to send comments about NHI. The deadline for submissions is October 11. This interim committee will decide what benefits will be covered by NHI, and at what cost. The benefits are of extreme interest as the proposed NHI law says medical aids cannot pay for services covered under NHI, but only for “complementary cover” for care not covered by the NHI fund. This was a key talking point at Wednesday’s round-table discussion at Wits University’s School of Law. The Helen Suzman Foundation believed “the NHI Bill is far too important and complex to be adequately engaged within this short comment period”. Be patient, says NHI head But senior government official and head of the NHI office Dr Nicholas Crisp was unperturbed, saying an act of law could not be too detailed because its aim was to create an “enabling environment” for further regulations. The bill proposes a major upheaval of the health system, with a single government-run fund buying all the healthcare in the country. The bill has been sent to parliament for discussion. But experts said it was difficult for people to make “informed” comments because the suggested law does not say what type of healthcare services the fund will buy and what it will cost. Crisp, consultant to the department of health and head of the NHI office, said at the discussion: “It will cost as much as we can afford. Pay what you can, to get what you can get.” The dean of the Wits Department of Commerce, Law and Management, Imraan Valodia, seemed unimpressed: “I hear you say this can cost anything we want it to cost. As someone who is concerned about taxation and public finances, this leaves me very uneasy. We are about to embark on what appears to be a really important social change. “If we are going to be entering this thing without even some kind of radar of what the likely costs are going to be, it does seem to me we are stepping into a minefield.” Advocate and former lawyer at Section 27 Adila Hassim said the bill only provided the “bare bones”. “It is not enough for the drivers of the process to say trust us ... because we have got your interests at heart ... We need to see more on the money front.” She pointed out that Crisp had not answered Valodia’s question. “You haven’t answered Imraan’s questions … What is it going to cost … even in the immediate term?” She said consumers did not know what to expect, “We don’t know what the benefit package is. We don’t know what it will cost, because we don’t know what it is.” Legal action is a possibility Werksmans medical lawyer Neil Kirby Werksmans said people needed to know what health treatments or benefits would be available, in order to respond to the bill in an “informed” way. “We don’t know what we are talking to. If the benefits were around and we knew what they were we would know what we are fighting about or not.” But Crisp defended the vague bill, saying “health reform of this magnitude was a long journey ... not a sprint”. “There are so many issues out there, that you simply cannot address with the bill.” The benefits are yet to be determined by committees of health experts, who are still to be appointed by the health minister. Crisp admitted there was ambiguity and confusion in the bill. “I have no doubt there are things in the bill that mean one thing to one person and mean something different to someone else.” But this would be resolved when “we put our heads together”. Werksmans’ Kirby called for calm, but warned that if decisions were not reasonable, people would head to court. “Level heads will prevail, but if they don’t, we will get level heads in court to ensure they [level heads] prevail.” Crisp said the government was ready for legal and constitutional challenges to the bill once it was law. “People challenge things all the time.” The government was expecting challenges for “years” to come. “That is the nature of how we make laws in our society, anyway.” As the evening closed, an audience member and senior education researcher, Dhianaraj Chetty, said he was “not impressed” with how the health department had handled the NHI bill. “It’s clear from the responses that there are so many issues out there that you simply haven’t addressed in the bill.” He said the government had been working on the bill since at least 2011 when it was first drafted. Crisp said it was first discussed in 1992. Chetty said: “We have had this discussion for so long. If you did not anticipate these issues ... what were you doing? “How can you bring us a bill [with so many holes] that you could drive a truck through it, on so many issues?”
Created at 2019/09/20 12:54 PM by Mediclinic
Last modified at 2019/09/20 12:54 PM by Mediclinic