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Focus on National Health Insurance

Doubt raised over the schemes feasibility


WITH almost 80 percent of the population unable to afford healthcare, the National Health Insurance (NHI) scheme proposes targeting the ‘rich’ to subsidise the ‘poor’.

Contained in the NHI draft white paper, these proposals were discussed between uThungulu district leadership and NHI representatives in Empangeni last Tuesday.

The paper, a preliminary report outlining the scheme’s expected ramifications, has raised concerns since published in December.

uThungulu officials questioned how the scheme would be funded, who would benefit and whether existing health infrastructure would be able to handle the influx of new patients.

Deputy Director General for the NHI scheme, Mfowethu Zungu, said all citizens would make compulsory contributions to the scheme.

Using these contributions, government would ‘pre-purchase’ healthcare services from accredited public and private health institutions so that lower income earners could gain access to healthcare for free.

Existing private medical schemes, however, would only be allowed to offer ‘complementary services’ to these patients which were not provided by the NHI.


‘Our task going forward is to ensure that healthcare becomes affordable,’ said Zungu.

‘If we can harness our resources and have the rich subsidising the poor and the healthy subsidising the sick, we will avoid a system which reserves healthcare for the minority with medium to high incomes.’

Launched in 2012, the scheme is being implemented in three phases over 14 years, with the 2016/17 financial year marking the end of the first, pilot phase.

Finance Minister Pravin Gordhan budgeted R4.5-billion for the renovation of healthcare facilities in all eleven NHI pilot districts.

‘I’m satisfied with how the pilot phase is unfolding,’ said Zungu.

‘However, the most essential challenge we have identified is the need to invest in uplifting primary care services to stop healthcare from becoming expensive and complicated later on.’

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