Concern over govt health scheme

Johannesburg - The proposed National Health Insurance scheme came under the spotlight again on Friday, with a health economist raising concerns about its viability.

President Jacob Zuma touched on the introduction of an NHI during his state of the nation address on Wednesday, but there is a growing call from the private health care sector for details on how the ruling ANC's plan to achieve affordable universal health care will work.

The Hospital Association of SA (Hasa) issued a statement saying that health economist Alex van den Heever told their conference in Durban that from what he knew of the NHI, the system was a "completely unworkable, unaffordable solution that won't improve health services despite massive increases in expenditure".

Van den Heever said one of the proposals put forward in the yet-to-be released document compiled by the African National Congress task team researching the matter, was increasing the health budget by R100bn.

It also proposed introducing a tax to all employed South Africans to create universal access to health care.

According to ANC spokesperson Jessie Duarte the document would be released after committee chair Zweli Mkhize gives the go-ahead.

Van den Heever said: "The danger is that there seems to be an attempt to avoid debate on this issue.

"The documents have been produced, but have not been subjected to external peer review or technical analysis," he was quoted as telling conference delegates.

According to Van den Heever, medical scheme members would pay 85% of their contributions, irrespective of the option they were on, to a global fund which would pay both public and private sector providers.

Non-medical scheme members would have to pay five percent of their income to the fund.

"Medical schemes would only be able to cover benefits that were not covered by the NHI," he said.

Van den Heever was concerned that the legislation implied huge institutional changes that "have not been rationally motivated or subjected to sufficient scrutiny".

"The problem with our health system is clearly not only about how much, but rather how well the public funds are spent."

Van den Heever also raised questions about the "massive bureaucracy" of registering everyone for the system, issuing identity cards and making the system "fraud proof".

"The proposed changes would introduce a complexity into the health system that would outweigh any benefits."

Hasa said that Deputy Health Minister Molefi Sefularo said the document would be released in June and would be circulated for comment.

Business Unity SA chief executive officer Jerry Vilakazi told the conference the private health care sector should be prepared to discuss the matter with the department of health.

"As the private sector we dare not walk away if we fail to make our positive contribution otherwise we will run the risk of being saddled with a significant, far-reaching policy which doesn't take into account the valuable contribution the private sector can make to making health care more equitable," said a statement containing Vilikazi's comments at the conference.

He added that it would not be in anyone's interest to rush through the matter as it needed to be premised on a sustainable funding model.

The NHI forms part of the ANC's election manifesto to deliver more equitable health care to everyone. NHI schemes are used in many country's around the world, including the United Kingdom.

- Sapa