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Medical Scheme increases and the prospect of NHI

February 21, 2019

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Devlin Ross, Healthcare Consultant at Chartered Employee Benefits, suggests that a hybrid NHI model, suited to a South African context, is the way forward.

Update from the SONA

President Cyril Ramaphosa announced at the SONA that NHI would be implemented while the government continues to improve state facilities.

While his undertaking is important, his promise conflicts with the White Paper on NHI which states that the government will first focus on improving the state structure and then move forward with the implementation of NHI.

It seems the lack of certainty continues when it comes to a concrete plan for implementing universal healthcare in South Africa.

The need for NHI

Most, if not all, South Africans would agree that we need universal healthcare, as the current healthcare system reveals an imbalance where only those that can afford to belong to a Medical Scheme have access to quality healthcare … albeit at an exorbitant price!

We could argue that we currently have a universal healthcare system, since South Africans pay taxes which are used to fund public healthcare that the majority of South Africans have access to at no charge.  South Africa apportions one of the highest percentages of its income to healthcare; it is the efficiency in the management of that money that can be questioned when we consider the poor quality of most of our state hospitals.

While a Medical Scheme attempts somewhat to justify these cost increases by highlighting enhanced benefits, we have yet to see a significant enhancement that would justify the costs.

The biggest contributing factor to these increases is said to be the year-on-year increase in utilisation, which is a combination of supply-induced demand together with technology, and ageing members.

As a result of these increases, we have seen corporates reducing subsidies or moving toward a cost-to-company benefit. Individual members are also looking to downgrade with as little impact as possible on their benefits.

Light at the end of the tunnel?

A step in the right direction would be for South Africa to realise the potential within the NHI system to create a hybrid model that fits our complex healthcare environment.

The success of an efficient universal healthcare solution will hinge on the appropriate management of funds and limited resources in the GP, Specialist and Nursing professions. The key is for the government to work together with the private sector and benefit from the experience the private sector has to offer.

Universal healthcare is incredibly complicated with many different aspects to consider; even the United Kingdom has yet to get it 100% correct,  and they have had over 70 years building their system.

South Africans are faced with a dismal outlook when it comes to affordable quality healthcare but there is some hope.

Low-Income Medical Schemes could be a real solution.

Even Bill Gates believes that primary care can be provided throughout Africa at a relatively low cost when compared to the implementation of a universal healthcare system. We believe that Low-Income Medical Schemes are an essential part of the overall goal of quality affordable healthcare.

The Budget Speech 2019: To harvest, you have to plant

Eskom was expected to feature prominently of the FinMin’s Budget Speech this year.  Click here to find out how the Budget Speech impacts you, with a comment from Chartered Employee Benefits CEO, John Campbell.

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