The government’s plan to create a national healthcare programme will likely result in higher taxes, Health Minister Aaron Motsoaledi told the South African Broadcasting Corporation (SABC) on Monday.
”Those who earn better will pay more,” Motsoaledi said.
The SABC reported that details of the programme are expected later this week and that some are estimating its costs to hit R100-billion.
”Those of us who earn better pay more tax. All government functions work like that —,” said Motsoaledi.
The proposed National Health Insurance (NHI) scheme came under the spotlight again last week, with a health economist raising concerns about its viability.
President Jacob Zuma touched on the introduction of an NHI during his State of the Nation address last week, but there is a growing call from the private healthcare sector for details on how the ANC’s plan to achieve affordable universal healthcare will work.
The Hospital Association of South Africa (Hasa) issued a statement saying that health economist Alex van den Heever told its conference in Durban that from what he knew of the NHI, the system was a ”completely unworkable, unaffordable solution that won’t improve health services despite massive increases in expenditure”.
According to ANC spokesperson Jessie Duarte the document would be released after committee chair Zweli Mkhize gives the go-ahead.
Van den Heever said: ”The danger is that there seems to be an attempt to avoid debate on this issue.
”The documents have been produced, but have not been subjected to external peer review or technical analysis,” he was quoted as telling conference delegates.
According to Van den Heever, medical scheme members would pay 85% of their contributions, irrespective of the option they were on, to a global fund that would pay both public- and private-sector providers. Non-medical scheme members would have to pay 5% of their income to the fund.
”Medical schemes would only be able to cover benefits that were not covered by the NHI,” he said.
Sufficient scrutiny
Van den Heever was concerned that the legislation implied huge institutional changes that ”have not been rationally motivated or subjected to sufficient scrutiny”.
”The problem with our health system is clearly not only about how much, but rather how well the public funds are spent.”
Van den Heever also raised questions about the ”massive bureaucracy” of registering everyone for the system, issuing identity cards and making the system ”fraud proof”.
”The proposed changes would introduce a complexity into the health system that would outweigh any benefits.”
Hasa said that Deputy Health Minister Molefi Sefularo said the document would be released in June and would be circulated for comment.
Business Unity South Africa CEO Jerry Vilakazi told the conference the private healthcare sector should be prepared to discuss the matter with the Department of Health.
”As the private sector we dare not walk away if we fail to make our positive contribution otherwise we will run the risk of being saddled with a significant, far-reaching policy that doesn’t take into account the valuable contribution the private sector can make to making healthcare more equitable,” said a statement containing Vilikazi’s comments at the conference.
He added that it would not be in anyone’s interest to rush through the matter as it needed to be premised on a sustainable funding model.
The NHI forms part of the ANC’s election manifesto to deliver more equitable healthcare to everyone. NHI schemes are used in many country’s around the world, including the United Kingdom. — Sapa