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Johannesburg - South Africa would still have a dual healthcare system - both private and public - should the proposed National Health Insurance (NHI) scheme become a reality, but at a much higher cost to taxpayers, analysts said on Wednesday.
On Tuesday, the chair of the ANC's sub-committee on health Zweli Mkhize lead discussions on the NHI at the party's national general council meeting (NGC) in Durban. His proposals were much more pragmatic than an earlier framework.
For example, the plan is to phase the system in over 14 years, instead of the originally envisaged five years. The ANC also admitted a free and universal health coverage system would increase demand for services by about 80%. To cater for supply pressures, the ANC aims to train about 80 000 more healthcare workers.
"Although this is still ambitious in relation to international experience, it (the revised proposal) is definitely more reasonable," said economic research group Econex's Nicola Theron.
Individuals and healthcare institutions would be able to choose whether they want to be part of the system, but everyone will have to contribute financially.
Aside from a surcharge on taxable income, the ANC envisages the NHI to be funded by payroll taxes for employees and employers, an increase in value-added tax (VAT) dedicated to the NHI and a removal of the existing tax subsidy for medical aids.
The NGC will also debate how the quality of public health needed to be improved to introduce the NHI successfully. But Econex questioned whether it would not be better to spend the money the government says it has for the NHI (R128bn in its first year, going up to R376bn by full implementation in 2025) on overhauling the existing public health system.
It was still unclear what cost estimates for the NHI include. However, Econex research showed not much would change under a universal system unless underlying inefficiencies and skills shortages in the public sector are addressed.
Made for appeasing restless ANC masses
This meant that if there was no significant improvement in public health services, people who currently contribute to medical aids would probably continue to do so while maintaining their contribution to the NHI.
This, said Econex, would leave South Africa with a system the same as the one it has. However, those opting to stay private would have to make the additional contribution to the NHI system.
Robert Schrire, head of the political science studies department at the University of Cape Town, said a universal healthcare system is a highly technocratic one and should not be a party political decision.
However, he said the ANC has to give its members some "bread and meat" at this NGC to ease the pressure points that have been building up in the party. But it has to do this with the least amount of damage possible to the economic policy framework. The toned-down and more pragmatic NHI plan that's been tabled is the answer to this.
While Schrire agreed that the focus should be on fixing the existing public health system, he said the issue is not so much about wasteful use of resources as it is about trotting out something to placate a build-up of impatience among ANC supporters.
- Fin24.com
On Tuesday, the chair of the ANC's sub-committee on health Zweli Mkhize lead discussions on the NHI at the party's national general council meeting (NGC) in Durban. His proposals were much more pragmatic than an earlier framework.
For example, the plan is to phase the system in over 14 years, instead of the originally envisaged five years. The ANC also admitted a free and universal health coverage system would increase demand for services by about 80%. To cater for supply pressures, the ANC aims to train about 80 000 more healthcare workers.
"Although this is still ambitious in relation to international experience, it (the revised proposal) is definitely more reasonable," said economic research group Econex's Nicola Theron.
Individuals and healthcare institutions would be able to choose whether they want to be part of the system, but everyone will have to contribute financially.
Aside from a surcharge on taxable income, the ANC envisages the NHI to be funded by payroll taxes for employees and employers, an increase in value-added tax (VAT) dedicated to the NHI and a removal of the existing tax subsidy for medical aids.
The NGC will also debate how the quality of public health needed to be improved to introduce the NHI successfully. But Econex questioned whether it would not be better to spend the money the government says it has for the NHI (R128bn in its first year, going up to R376bn by full implementation in 2025) on overhauling the existing public health system.
It was still unclear what cost estimates for the NHI include. However, Econex research showed not much would change under a universal system unless underlying inefficiencies and skills shortages in the public sector are addressed.
Made for appeasing restless ANC masses
This meant that if there was no significant improvement in public health services, people who currently contribute to medical aids would probably continue to do so while maintaining their contribution to the NHI.
This, said Econex, would leave South Africa with a system the same as the one it has. However, those opting to stay private would have to make the additional contribution to the NHI system.
Robert Schrire, head of the political science studies department at the University of Cape Town, said a universal healthcare system is a highly technocratic one and should not be a party political decision.
However, he said the ANC has to give its members some "bread and meat" at this NGC to ease the pressure points that have been building up in the party. But it has to do this with the least amount of damage possible to the economic policy framework. The toned-down and more pragmatic NHI plan that's been tabled is the answer to this.
While Schrire agreed that the focus should be on fixing the existing public health system, he said the issue is not so much about wasteful use of resources as it is about trotting out something to placate a build-up of impatience among ANC supporters.
- Fin24.com
