News24.com | LIVE | #NHIBill: Main source of NHI funding will be \'appropriations\, general tax revenue\'

LIVE | #NHIBill: Main source of NHI funding will be 'appropriations, general tax revenue'

2019-08-08 10:00

The National Health Insurance (NHI) Bill is officially being introduced to Parliament.

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Last Updated at 11:25
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Questions are now being fielded, as Minister Mkhize needs to leave the briefing at 11:30 for another engagement.


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READ IN FULL - National Health Insurance (NHI) Bill: 

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Another "Friends of the NHI" representative, speaking on behalf of Discovery Health CEO Dr Johnathan Broomberg: "We welcome the publication of the NHI bill, as this provides more clarity on the implementation of the policy objective of universal health coverage, and the establishment of the NHI fund. We support the drive towards ensuring that all South Africans have access to quality health services based on need, rather than affordability and we welcome the minister's collaborative approach in working towards this objective."

"The NHI fund will be an important enabler for harnessing private sector collaboration."


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A representative of the Pharmaceutical Manufacturers Task Group, which is an umbrella constituent organisation representing all five pharmaceutical industry associations, is next at the podium as one of the "Friends of the NHI". 

"The PTG and the South African pharmaceutical industry at large, looks forward to partnering with government, more specifically the national Department of Health in ensuring sustainable business models that are able to appropriately support government's efforts at ensuring secure, affordable and accessible medicine supply, as a viable and affordable NHI system unfolds..."


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In a statement read out from the Healthcare Federation of SA's Professor Chetty: "The Healthcare Federation of South Africa is supportive of the initiative for NHI in South Africa. The Independent Practitioners' Association in South Africa fully supports and endorses the need for universal healthcare NHI in South Africa. Our support was demonstrated on the 21st of July 2019 at the ICC in Cape Town, when we launched the Healthcare Federation of South Africa..."


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A representative from the South African Medical Association (SAMA), National Chairperson Angelique Coetzee, says they "welcome the bill".

Coetzee thanks Mkhize for not giving up on the heavily contested bill.


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The SACP follows Cosatu at the podium, and then a representative from SANAC, as another of the "Friends of the NHI".

"We are fully behind the ANC-led government, the president, the minister, deputy minister, all progressive MPs... ultimately this will be enacted in Parliament and the civil society formations that are involved in ensuring that we realise the NHI in our lifetime. We will use the power and influence we have to be active agents in this journey," says Mfundisi from SANAC.



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Next up is Cosatu, with their position on NHI.


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Pillay on Section 10, which deals with financial matters: "The main source of funding is appropriations, which is from Parliament into the fund, and the chief sources of income for the appropriations are general tax revenue, funds that may be shifted from the provincial equitable share and conditional grants into the fund. A reduction in the medical scheme tax credits over time, the possible consideration of a payroll tax as well as a surcharge on personal income tax, which the National Treasury will announce from time to time."

Pillay says the fund must be audited and the Auditor General of South Africa is required to perform audits over the fund. The fund must also produce annual reports about its financial performance, as well as its performance in delivering services.


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Once NHI is fully implemented, regulations will be introduced to limit benefits to services not reimbursable by the fund.


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Mkhize makes way for Dr Pillay, who is highlighting some of the important sections in the bill.


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The bill will be available in print and digital straight after this briefing. 

Mkhize: "The objective of the NHI, is to achieve universal access to quality healthcare services in the republic, in accordance with Section 27 of the Constitution, through the establishment of the NHI Fund. It is based on the principles of social solidarity where we look after each other in times of medical need..."


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Proceedings have kicked off, being led by Health Minister Zweli Mkhize.


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'Govt's NHI will kill the private health sector', warns DA

The DA, which strongly opposes the government's National Health Insurance (NHI) plan, believes it can provide universal health care without pooling private and public funds as well as creating another state-owned enterprise (SOE).

"The global trend in public health is to move toward providing universal health care. It is crucial that South Africa follows suit. With an accumulative budget of more than R222bn across all provincial departments and its entities, this is a possibility for our country, but the devil is in the detail," said DA MP and spokesperson on health Siviwe Gwarube in July.

Gwarube said South Africa's current two-tier health care system was unsustainable and had over the past two-and-a-half decades created an environment of insiders and outsiders - with 16% of South Africans having health care coverage and over 80% "relying on the crumbling public health system".


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There are many questions around the NHI bill. For instance, will you be able to have a comprehensive medical aid? 

The answer is no. Once the NHI has been fully implemented, your medical scheme will not be allowed to cover any health services that the NHI offers. You will have to use the NHI for those services. Your medical aid will only be able to provide you with complimentary cover, in other words, services that the NHI doesn’t cover. By when will your medical aid, in its current form, disappear? According to the Bill, the NHI Fund needs to be up and running by 2026 through a system of "mandatory prepayment".Many experts, however, argue that the NHI will take much longer to take off.  

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