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COVID-19 – Stepping Stone for NHI in South Africa?

June 23, 2020

Unified Response

As the country navigates the mechanisms to reduce the impact of the Coronavirus, the pandemic has further exposed the existing socioeconomic inequalities in South Africa.

So far, the unified response from the Healthcare sector has been a success story, showing the capability of pooling resources from the private and public sector; and making these available to all South Africans.

We are seeing initiatives such as the availing of free virtual consultations through collaboration between Momentum’s Hello Doctor, the Department of Health, Discovery Health, Vodacom and Bonitas 24/7 Virtual Care, to name a few. We are also witnessing unprecedented goodwill among healthcare professionals and civil society activists in dealing with COVID-19.

Genesis of an NHI

During a virtual forum earlier this month, organised by SANEF (South African National Editors’ Forum), President Cyril Ramaphosa said, “This could well be seen as the genesis of a NHI”. He mentioned that COVID-19 has not only presented us with enormous challenges; but it has also created several opportunities that we must capitalise on.

There are still unresolved matters between the public and private sectors, although the negotiations are still ongoing. There is an understanding that both sectors will work together in ensuring that the healthcare system is not overwhelmed once the pandemic reaches its peak. If the camaraderie continues, this could translate to good relations forming, which will be beneficial to the full implementation of NHI.

The Department of Health has confirmed that the current COVID-19 response initiatives are being used as a building block for the realisation of NHI. The financial strength of South Africa’s healthcare sector is being tested, with the public sector directing R20 billion of the government’s COVID-19 fiscal response package towards health and other frontline services.

The pandemic has bolstered the government’s work toward the improvement of the healthcare systems and infrastructure. South Africa has reported 52% of COVID-19 recoveries through the public sector, which serves as a testament to the effectiveness of the work being done.

Private Healthcare response- COVID-19

The Council for Medical Schemes (CMS) has declared COVID-19 as a Prescribed Minimum Benefit, which means all registered medical schemes are required to cover the prescribed basket of care related to this condition. The medical scheme industry has projected cost estimates in the region of R31.8 billion for the funding COVID-19 related claims.COVID-19 related treatment on healthcare insurance policies will be subject to the insurance policy benefit schedules. Health insurance policyholders, as well as medical scheme members, are strongly encouraged to check their policy documents and plan benefits, as well as reach out to their financial service providers for confirmation of benefits.

Looking Forward

With the majority of healthcare resources being directed at COVID-19 initiatives, the Healthcare sector should not lose sight of the other challenges facing the industry, such as the higher mortality rate from non-COVID illnesses, regulatory reforms and increased medical malpractice litigation.

The government is firm on the stance that NHI is on the horizon, the much-needed revamp of healthcare systems and infrastructure in the public sector is a tangible step toward improving the quality of Healthcare services overall. A key component to an improved healthcare system with fewer barriers to accessibility, remains the efficient utilisation of available resources steered by effective governance.

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