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Comment Sought on Draft NHI Bill

June 25, 2018

Department of Health

The Draft National Health Insurance (NHI) Bill has been published for comment.

The health department published the draft bill in Government Gazette 41725.

The NHI White Paper was published in June 2017.

It sets out government’s proposals to put a universal health coverage system in place.

The draft bill aims to:

• provide mandatory prepayment health care services in the Republic in pursuance of section 27 of the Constitution;
• establish a National Health Insurance Fund and to set out its powers, functions and governance structures;
• provide a framework for the active purchasing of health care services by the Fund on behalf of users;
• create mechanisms for the equitable, effective and efficient utilisation of the resources of the Fund to meet the health needs of users;
• preclude or limit undesirable, unethical and unlawful practices in relation to the Fund and its users; and
• provide for matters connected herewith.

The NHI aims to pool funds to provide access to quality and affordable health services for all South Africans based on their health needs and irrespective of their socio-economic status.

It is described as representing a substantial policy shift that will require a significant re-organisation of the current health care system, both private and public.

The vision is that health care should be regarded as a social investment and not subjected to market forces.

The White Paper focused on structural problems in the health sector, the burden of disease, the rationale and benefits of NHI, NHI coverage, organisation of the health care system and services under the NHI, financing of NHI, purchasing of health services and phased implementation.

7 NHI Implementation Structures were set up in July 2017.

Comment is invited within three months of the date of publication.

The Draft Medical Schemes Amendment Bill has also been published for comment.

The health department published the proposed legislation in Gazette 41726.

Inter alia, the draft bill seeks to amend the Medical Schemes Act in order to exclude the application of the Consumer Protection Act in relation to matters governed by the act, set up a central beneficiary register, provide for a health care providers register, introduce an enhanced system of governance of medical schemes and empower the council to determine broker fees from time to time.

According to the health minister, Aaron Motsoaledi, the draft bill aims to, amongst others, abolish co-payments, stop the practice of using brokers within the medical schemes environment, abolish prescribed minimum benefits and replace with comprehensive service benefits, declare the carrying on of the business of a medical scheme by a person not registered as a medical scheme to be a specific offence and the cancellation of membership and waiting periods between joining a scheme and accessing benefits.

Comment is invited within three months of the date of publication.