What Next For The NHI?
Forbes Africa|December - January 2021
There has been enough debate and deliberation around South Africa’s proposed National Health Insurance Bill for unified health coverage. Covid-19 has turned the spotlight on it again, and there’s more news expected in February 2021.
Chanel Retief

I feel good,” were the last words 33-year-old Charlie Mpogeng remembers his brother, Herman Motlhabane, saying to him before his untimely passing on the morning of July 17.

Motlhabane died, his relatives not knowing it was because of Covid-19 as his test results were only made available two weeks after his passing.

He had complained of a flu before being hospitalized.

“It was during that time of mass hysteria when everyone was like ‘if you have the flu, have it checked out’,” Mpogeng remembers as he walks to his brother’s grave at Westpark Cemetery in Emmarentia, west of Johannesburg. Even as he speaks, a tractor is digging up more graves around him, for other hapless victims who have succumbed to Covid-19.

By the end of July, 1,932 people had died of the pandemic in South Africa’s Gauteng Province, Motlhabane one of them.

With a disruptive virus still on the prowl to claim more unsuspecting lives, political establishments everywhere are sitting up and revisiting their healthcare systems – or the lack of it.

In South Africa, the focus has returned to the National Health Insurance (NHI) Bill, proposed to improve and strengthen the health financing system and provide quality, affordable medical care to all.

“The pandemic also showed the need for the public and private healthcare sectors to work together,” Dr Zweli Mkhize, the country’s health minister, said at a press briefing in October. “This is one of the core principles of the NHI.”

To further enable this, the National Health Laboratory Service (NHLS) and The National Institute For Communicable Diseases Of South Africa (NCID) have fallen under one umbrella, to ensure tests are adequately and accurately captured, but also to ensure labs can exchange skills, information and resources as and when the need arises.

“At the start of the pandemic, there was a critical shortage of test kits. At that time, the labs would count all the kits that were available in the country and then distribute them equitably amongst each other, regardless of whether the lab was private or public and it’s important to point out that both public and private labs co-sponsored each other in ensuring equitable distribution,” Popo Maja, the spokesperson for the national Department of Health in South Africa, tells FORBES AFRICA.

Healthcare workers were counted as “one workforce” during these dire times, working freely between public and private sectors and some moving to work at field hospitals. Due to the high demand for hospital beds for Covid-19 patients, the government agreed with private hospital groups about pricing and acceptance of state patients. According to Maja, such negotiations have previously taken years and were often facilitated by lawyers and courts, at times without resolution.

WHO QUALIFIES FOR NHI IN SOUTH AFRICA?

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