South Africans are concerned about how the government plans to mitigate fraud and corruption under the National Health Insurance (NHI) as well as the pricing of the new health system. There is also still a sense of uncertainty with insufficient detail on how the NHI will be administered. These are some of the discussion points that have come out of a webinar drawing on lessons from the COVID-19 pandemic and looking at the way forward for the NHI.
The webinar was organised by the Government Employee Medical Scheme and the Mail and Guardian.
Fraud and corruption seen during the COVID-19 pandemic has also raised many questions about how the government plans to mitigate it happening under the NHI. Doctor Nicholas Crisp, advisor to the Minister of Health on implementation of the NHI Fund says they will fight corruption.
“There’s a whole unit to deal with both internal fraud and corruption and the external investigation arm. And you’ve heard about the body that’s been put together with all the law enforcement agencies by the president actually. All I can say is that we are equally concerned as any other citizen that this needs to be sorted out in the systems.”
NHI funding
The funding and cost of NHI remains a thorny issue as taxpayers want clarity on how the health system will affect their pockets.
“NHI is going to be administered at a very low level. It is possible for an effectively administered NHI to be run at around 2-3 % of the total cost. When we look at how much we are spending as a country on health already, we are spending quite substantially and this has to be used using the principle of solidarity where we cross-subsidise each other,” says the Technical Advisor on NHI Dr Aquaila Thulare.
She says COVID-19 has actually been a blessing in disguise.
“The pandemic has actually brought the public and private sectors closer together. For the first time, I mean, we were able to have some conversations on how we could streamline the service delivery platforms. And the second thing is that for the first time there’s been a mechanism that has been initiated where we could start discussing how we could price services so that we do not break the bank and we provide services in an affordable way.”
Money to be saved through NHI
The Government Employee Medical Scheme, GEMS, says there is a lot of wastage in the current health system and millions of rands will be saved when we move to the NHI.
“Families have to register with specific GPs and these GPs become responsible for the healthcare of that family up to and including referral. And the referral system is important in all of this because members only go to specialist care when they’ve been referred by their GPs. That has in our environment helped us to achieve downstream cost savings of up to 17%. All of these things are applicable in a level of the NHI,” says Principal Officer at GEMS Dr Stan Moloabi.
A poll that was run during the 90-minute webinar showed that 58% of the participants were in support of the NHI, 14 % opposed to it, and 27 % unsure because of insufficient information about the new scheme. The session was attended by close to 300 people.
Discussion on NHI:
