Tax on NHI not expected in short term
Johannesburg - A tax to fund the government's national health insurance (NHI) system will not be introduced in the short term, deputy director general public finance in the National Treasury Andrew Donaldson was reported as saying this week.
The Hospital Association of South Africa (Hasa) said on Friday that Donaldson had indicated that considering South Africa's constrained fiscus, it would be difficult to raise additional taxes at this stage.
He said discussion papers would be released early next year before financing arrangements for healthcare would be changed.
Minister of Finance Pravin Gordhan has raised several options for increasing the funding required for NHI, but "no decision had been taken on specific funding arrangements", Donaldson said.
There would also be continued provision for the revitalisation of hospitals, with major rebuilding projects such as at Chris Hani-Baragwanath hospital.
According to the Hasa statement, Donaldson said that increasing expenditure on public healthcare from 4% to 6.2% of gross domestic product - as estimated in the green paper on NHI - would place a substantial strain on the country's public finances.
He also highlighted that the shortage of supplies, nurses and doctors in the public sector would limit the amount that could be spent on NHI.
"A great deal of work also needs to be done to address bureaucratic barriers to service delivery," he said.
"Merging public and private procurement arrangements will be an important part of healthcare reforms.
"The integration of supply chain management between public and private sectors could help lower costs and bring modern logistics into the delivery of healthcare in the public sector," he said.
To counteract the shortage of doctors in state hospitals, follow the Austrlian route and 'force' ALL doctors (icluding those in private practise) to set aside 2 afternoons a week for what they call "bulk billing"
Doctors in this country have recently been 'forced' to do 2 years of internship in a government hospital instead of 1 previously. They are also 'forced' to do a year of community service in a post stipulated by the government...'forcing' them to do anymore would certainly chase away the few who haven't left for canada/uk/aus/nz yet
the shortage of doctors is only the tip of the iceberg anyway. You forget the shortage of nurses, physiotherapists, dieticians, etc etc. Not to mention shortage of linen, medical consumables, equipment, beds, a failing infrastructure, corruption, incompetence, arrogant staff attitude and the list goes on.
What is the possibility that when the NHI comes into effect, the private sectors will then accept NHI card holders? They will lose probably 90% of their current clients because most of us will not be able to afford NHI and a medical aid scheme. So in theory, private hospitals will make a major loss, due to the fact that there are no patients, forcing them to then accept NHI card holders? I am really not comfortable with ANY of the public healthcare. Don't want to lay in one of their beds bleeding to death with an excuse, eish, short staff or is my lunch break.
re the use of "NHI cards" at Private sector: This is the only way state will be able to provide treatment to all. It will in all probability be in the form of a PPP (Public Private Partnership) There are already a few running in the country.
STRANGE! Was it not said that no additional taxation shall be required for funding of the NHI?
the govt can throw billions at NHI but what happens when all the best doctors and nurses move overseas?
i still maintain that the problem to service delivery is not lack of funds. it's mainly misappropriation of funds and lack of skilled management to oversee the utilisation of advanced funds. the govt must stop playing dumb and confront the real issues they have. this is sickening.