Cape Town - The yardstick for how much people will pay for national health insurance (NHI) is their current contribution to medical funds.
Dr Yogan Pillay, deputy director general for health, told the parliamentary standing committee on budgets that the plan for the NHI system was to try to ensure that individuals do not exceed their currrent medical aid costs.
Pillay said that revenue sources for the NHI need to be as broad-based as possible, so that smaller contributions are required.
He said that the cost of the NHI, at R255bn in real terms (what it would cost today), was merely an estimate.
Two weeks ago the department of health issued the first NHI policy document.
It said that greater clarity as to the final cost would be obtained closer to the NHI's implementation.
For the next five years pilot projects would be introduced at district level, which would give a better estimation of costs. The overall cost structure would then be refined.
Dr Mark Blecher, social services director at the National Treasury, said the NHI would not be introduced overnight.
The Green Paper makes provision for a 15-year transitional period, during which the national healthcare system will be gradually strengthened.
Certain objectives will be achieved in three phases. The first five years involve the five pilot projects, as well as the bolstering of the public sector. The second phase includes pilot projects on contracting with the private sector.
Blecher said the NHI will be funded by way of the finance minister’s preserve. For the next six months feedback on the options for a financing mechanism is to be given to the portfolio committee on finance.
A discussion document on the matter will shortly be issued by Treasury, after which comprehensive consultation will take place.
He said that the minister of finance alone has the power to introduce compulsory taxation and levies, and the final decision will be within ministerial jurisdiction.
Blecher said it was too soon to say when contributions to the NHI will start. These details will be dealt with in the discussion document on finance.
Director general Precious Matsoso added that before the funding mechanism is examined, the pilot projects will be implemented to determine costs.
She said that healthcare delivery needs to be transformed and the healthcare system upgraded before the funding mechanism can be introduced.
What is needed is a radical change of administration and management and a putting together of a comprehensive package of care on the basis of restructured primary healthcare.