We simply can’t afford the NHI

The only topic that would probably knock load shedding, potholes, corruption and Springbok-mania off the agenda around a braai is the National Health Insurance (NHI) Bill.

It was given the green light this month by the National Council of Provinces after being rushed through and now President Cyril Ramaphosa will decide what to do next.

It will no doubt head to the courts, whatever he decides. An opinion piece in today’s Business section by Moneyweb’s Ciaran Ryan makes for interesting reading.

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Having listened to a presentation from Discovery CEO Adrian Gore, he says: “The financial impacts of the NHI are potentially horrifying.

Discovery estimates the NHI will cost R859 billion for prescribed minimum benefits against the 2023 public healthcare budget of R233 billion.

Where will government get the R626 billion shortfall? “That’s where the NHI plan seems to run aground.

Apart from roughly R100 billion in tax credits and government employer medical scheme subsidies, roughly R528 billion will have to come from raising personal income tax.

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Expressed another way, that’s the equivalent of an 82% increase in personal income taxes. And this from a small and shrinking taxpayer base.

This means medical scheme members will be required to pay 31% more tax and receive 69% less benefits in return.” It just doesn’t make sense, especially when you consider unrealistic comparisons with the National Health Service (NHS) in the UK.

Gore says the proposed cover of R714 per person per month – a quarter of what the NHS costs – “is unlikely to come close to meeting the NHI’s prescribed minimum benefits”.

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He says the cost of private care is currently R2 332 a month – three times more than the NHI’s proposed R714 a month.

There is no question we need a better healthcare system. The gap between private and public sector healthcare in this country is unacceptable.

But until the entire system is reworked, we simply just cannot afford to make the change now.