Health experts have raised concerns around the planned funding of South Africa’s planned National Health Insurance, and who will be footing the bill.<\/p>\n
In a presentation to parliament, representatives from Stellenbosch University’s medical faculty said that they were broadly supportive of the introduction of universal healthcare coverage in South Africa.<\/p>\n
However, the department said it was not clear how the NHI could possibly be funded by an already strained tax base.<\/p>\n
“The sustainability of sources of funding is a concern, especially if the main source relies on a small taxpayer pool. How will this pool be affected by challenging economic times, high rates of unemployment and rising costs of fuel and food?”<\/p>\n
The medical experts said that there are already concerns around private medical aids in South Africa:<\/p>\n
“There is an assumption that private individuals are happy to make contributions to private medical schemes,” the group said. “Yet this is known to be a grudge expenditure due to uncertainties in quality that have come to represent public healthcare.”<\/p>\n
The health experts said that government will first need to eliminate wasteful expenditure and adopt lean management approaches throughout the system. Only then can it ask taxpayers to contribute – once the system has proven to be reliable.<\/p>\n
“Whatever taxes are proposed thereafter, bring taxpayers into your confidence and make them understand the justification for asking them to do what they are asked to do,” it said.<\/p>\n
The NHI currently makes no reference to the exact costs of the scheme once fully implemented.<\/p>\n
However, the department of health has said that that payroll taxes and a surcharge on personal income tax could be considered as sources of funding. Such taxes would need to be determined by National Treasury.<\/p>\n
At the start of May, the Council for Medical Schemes (CMS) said that the government\u2019s planned National Health Insurance is in full development, with plans to move to phase 3 of the programme from next year.<\/p>\n
In its 2021\/2022 annual performance plan, the CMS said that phase 3 will include mandatory pre-payment of the new scheme, contracting for accredited private hospital and specialist services, and finalisation and implementation of the NHI Act.<\/p>\n
\u201cThis (current) period coincides with the beginning of the second phase of the implementation of the NHI,\u201d the CMS said.<\/p>\n
\u201cThe CMS sees its role as playing both a supportive and a direct role in the delivery of all the activities according to the Act that should occur in the private sector.\u201d<\/p>\n