HASA proposal for NHI a win for universal health coverage – IRR

Government should embrace the universal health coverage alternative proposed by the Hospital Association of South Africa (HASA) and abandon National Health Insurance (NHI) dogma, says the Institute of Race Relations (IRR).

Says IRR campaign manager Makone Maja: “HASA accurately credits the African National Congress with first mooting the idea of making it compulsory for all formally employed South Africans to join a medical aid back in the 90s, an idea the Institute expressed support for when public comment was invited on the then NHI ‘Bill’.

“Included in the reporting on the proposal for compulsory medical aid enrolment of the formally employed is that this has received support from President Cyril Ramaphosa. The Institute counts this a heartening response and an indication of the President’s commitment to extending access to quality health care rather than NHI dogma.”

In its parliamentary submission on the NHI, the IRR called on the government to adopt a two-pronged approach to widening access to private health care: firstly, to do away with the obligation on all medical aids to provide prescribed minimum coverage; and, secondly, to permit low-cost benefit (LCB) options.

Compelling all medical aids to offer prescribed minimum benefits drives up the cost of medical insurance and limits access to private health care to a small minority who earn above the personal income tax threshold, which is approximately R19 750 a month.

The government can end this restriction by providing exemptions from the prescribed minimum requirements to LCBs, which would allow them to meet the basic needs of many South Africans and broaden the reach of private health care.

This approach, the IRR argues, would broaden access to health care as it would support the enrolment of many young and vigorously healthy citizens and lower the cost of such health services, while relieving the burden of providing public health care to the formally employed and their dependants. In this way, a great weight would be lifted off the shoulders of public health infrastructure and the resources would go much further in meeting the needs of the most vulnerable in society.

The IRR goes a step further in advocating a solution for the informally employed. It proposes that the government introduce state-funded health vouchers for the 12.4 million who are unemployed (on the expanded definition) and the recipients of disability and old-age pension grants. The health vouchers would be redeemable solely for medical scheme membership and health insurance. These vouchers would be funded by recouping the billions of rands in procurement spending that are wasted on fraud and inflated pricing. Much growth would be realised as the health-care needs of many more South Africans would be adequately met at a minimum cost.

It would also sustain the opportunities for medical tourism, a budding sector that sees many foreigners come to the country to make the most of. Estimates show that between 2018 and 2023, 27 458 tourists travelled to South Africa to seek affordable medical treatment. Retaining this booming group of cash-paying health-care users and cultivating this sector would further develop the health sector.

“These are solutions that fortify the constitutional values of access to health care, freedom and choice, while simultaneously placing the responsibility for health care on individuals themselves rather than on the state. These solutions bring nearer the opportunities for growth and development in the economy and in the lives of South Africans,” Maja concludes.

Media Contact: Makone Maja, IRR Campaign Manager Tel: 079 418 6676 Email: makone@irr.org.za 

Media enquiries: Michael Morris Tel: 066 302 1968 Email: michael@irr.org.za