Question:
What is South Africa's health policy in layman terms? I read about it, but what is it all about and how will this affect us as members belonging to a medical aid?
Answer:
Heidi Kruger, form the Board of Healthcare Funders, has this weeks answer:
At present there are two separate health systems in South Africa, i.e. the private sector and the public sector. Each of these sectors has their own specific challenges. The challenges in the private sector revolve around affordability and supply/demand issues. The challenges within the public sector revolve around issues such as, access, burden of disease, and, human resources.
The Green Paper on the National Health Insurance (NHI), released in 2011, proposes a single health system, which aims to:
- Provide improved access to quality health services for all South Africans.
- Pool risks and funds so that equity and social solidarity will be achieved through the creation of a single fund.
- Procure services on behalf of the entire population.
- Strengthen the under-resourced and strained public sector.
According to the Green Paper, the NHI will be based on two key principles, i.e. risk cross-subsidization (meaning that the young and healthy will cross subsidize the elderly and sick) and income cross subsidization (meaning that the people earning higher incomes will subsidize those earning less and the unemployed).
Medical schemes, as they are currently constituted, work under similar principles of cross subsidization mentioned above. In view of this, we believe that the private funding sector should be viewed as a national asset and which could be made available to government as it implements NHI.
In Board of Healthcare Funders of South Africa (BHF) submission on the Green Paper, BHF suggests that, once fully implemented, the NHI model could be similar to the 'Gautrain' model where the private sector was contracted by government to fulfil the function of building the entire system and where the establishment of the Gautrain Management Agency, under the Provincial Government, manages the running of Gautrain. We believe that a well functioning NHI system will certainly require such a model.
It must be noted, however, that the time-frame for the implementation of NHI, as stated by government, is 14 – 25 years, so it will not have an immediate effect on your medical scheme.