Polokwane resolution #8: National health insurance
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Resolution: The conference reaffirm the implementation of the national health insurance (NHI) system by further strengthening the public health care system and ensuring adequate provision of funding.
Progress: Though the NHI is yet to be made law, a pilot project is underway at 10 district hospitals across the nine provinces to test innovations that are needed for the implementation of the scheme.
The NHI will be rolled out over a period of 14 years and health minister Aaron Motsoaledi said government will add more pilot projects to those already existing in the next five years. The system is meant to ensure that everyone living in South Africa gets access to quality healthcare, regardless of their socio-economic status.
During the pilot projects, people using identified hospitals will only feel the benefits from the strengthening of the health systems through infrastructure revitalisation and improving service delivery. There will be no financial benefits yet for patients, as envisaged in the NHI green paper. Health Minister Aaron Motsoaledi said the funding structure used to finance NHI pilot projects was "neither intended to ensure that patients are not left with any out-of-pocket liabilities; nor to ensure that all providers, particularly district hospitals, are paid".
There's also a delay in contracting private doctors and signing a service agreement with the private sector. Clinical specialist teams consisting of gynaecologists and paeditricians should have been appointed for districts in December 2011, but that was not done. The fallback plan of reaching an agreement with medical universities to send professors to district hospitals on a rotational basis until the department can fill all permanent positions has also not been implemented.
Motsoaledi admits NHI won't work if the public health system is not functioning according to expectations, and fixing the healthcare system is a priority. Upon full implementation of the NHI patients should be able to visit private healthcare facilities without paying upfront and doctors will then have to claim from the NHI fund.