National Health Insurance

.By Gill Price

Our 30 Years of Freedom is a stark reminder of South Africa’s history of racial discrimination and segregation was reinforced by all the pre 1994 laws and policies – which included it provision of health services. The segregation of health services was used to further disempower the black majority population.

After 1994 government developed a National Health Policy to address the inequalities in health services to address the injustices of the past. The Constitution of the Republic of South Africa, 1996 is South Africa’s supreme law, requiring all legislation and policies to be aligned.

While the 1994 National Health Policy, as well as other health policies were implemented post-apartheid, they have not been able to address the structural deficiencies inherited from apartheid.

The increased unaffordability of private health care results in the increase of poverty as well as the reinforcement of segregation.

In response to the fragmented race-determined health system, government has been at pains to build a national democratic and equal access health system.

The R1.4 billion allocation from the 2024 Budget for the National Health Insurance (NHI) is a demonstration of the government’s commitment to this policy. 

The building blocks to ensuring universal health coverage is visible through various programmes such as the state-of-the-art, Limpopo Central Hospital, launched in July last year. 

The Limpopo Central Hospital is set to be one of the five flagship academic hospitals around the country and forms part of the country’s preparation for the implementation of the NHI. 

When visiting the hospital, patients will receive expert care, treatment, and management of complex conditions without having to travel outside the province. The hospital will have 488 beds and will be equipped with advanced medical technology and offer specialist services.

Speaking during the launch of the construction, Minister of Health, Dr Joe Phaahla said: “Healthcare professionals at the hospital will work collaboratively in a multi-disciplinary manner, ensuring comprehensive care and improved outcomes. It is expected that this hospital will in association with the health science faculty of the University of Limpopo make a significant contribution to health education and research.”

The hospital forms part of government’s infrastructure development programme aimed at improving the quality of life for all South Africans. Over 2000 jobs are expected to be created during the construction phase, and another 2000 once it is operational. 

The construction of the hospital comes at a time when the country is preparing for the implementation of the National Health Insurance. Over the next decade the government working together with all stakeholders will put in place the building blocks of a system that provides effective and efficient healthcare for all. The National Health Insurance Bill has already been passed by Parliament and waiting for President Cyril Ramaphosa to be signed into law.

Work is also underway to ensure that we have a fully functional NHI branch in the Department of Health in preparation for the transitional period. We are at advanced stage of filling forty-four technical positions that will consist of economists, public health medicine specialists, actuaries and lawyers. 

In October 2022, the National Health Normative Standards Framework for Interoperability in Digital Health was published. It outlines plans to establish a comprehensive national health information system that incorporates data from the private health sector. 

As the NHI slowly begins to take shape there have been those who have expressed doubt about its viability. At its heart, the NHI aims to draw on the combined strength of the public and private healthcare sectors, to ensure improved health outcomes for everyone. It will ensure that these two sectors complement each other so that our citizens have a choice of which sector to use with the service quality and pricing being more or less on par. 

The NHI paves the way for citizens to have access to quality healthcare services, as enshrined in the Constitution. The Constitution recognises healthcare as a fundamental human right.

The debate on NHI should no longer be about whether or not we should have universal healthcare in the country, it must be how best to implement it. We are aware as government that it cannot be introduced overnight; hence, we will be implementing it in phases over the next few years. 

Government remains confident that we will be able to implement it effectively if we stand together as one. We have demonstrated time after time that we are stronger together, and we will do so again as we ensure that no one is left behind from accessing quality healthcare.