What Is The National Health Insurance Bill And How Will It Affect Me?
Marie Claire South Africa|November 2018

Everyones talking about it, but is the National Health Insurance (NHI) Bill and its sister, the Medical Schemes Amendment (MSA) Bill the miracle cures for good quality universal healthcare in South Africa? Sarah Browning-de Villiers investigates if SA is about the swallow the right pill.

What is the NHI Bill, really? Fundamentally, the NHI Bill is aimed at ensuring that everyone has access to good quality healthcare, regardless of their income level. It is also a response to the UN declaration for all of its signatories to provide universal health coverage to their citizens by 2030. You could consider the NHI Bill as our version of the UK’s National Health Service (NHS). Sounds great, right? Of course it does. But even experts aren’t 100% sure when it will be passed, what its practical implementation will look like, and how effective it will be.

EQUAL HEALTHCARE ACCESS MATTERS

‘NHI is the government’s plan for comprehensive health services for all South African citizens,’ explains Dr Katlego Mothudi, the managing director of the Board of Healthcare Funders of Southern Africa. ‘It is aimed at ensuring everyone has access to good quality healthcare, without experiencing financial hardship in accessing it. The main purpose of the NHI Bill is to provide the legislative framework for establishing a fund that will ensure sustainable and affordable universal access to health services.

‘For this to happen, a considerable reorganisation of the current health system, both in the private and public sector, has to occur. The NHI fund is established in recognition of the need to improve access to quality health care and to protect the population from the rapidly escalating costs of private health cover.’

Sasha Stevenson, an attorney at SECTION27, a public interest law centre, adds, ‘Inequitable access to healthcare services is a huge problem in South Africa. About the same amount of funding goes into the public and the private sectors, but the public sector caters to over 80% of the population, whereas the private sector sees less than 20%. The idea behind NHI is to pool all health funding into one fund that can then buy services from both the public and the private sectors.’ It is an important step towards balancing the deepening inequality between rich and poor South Africans – something that needs to happen.

HOW WILL IT WORK?

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