{"id":1508,"date":"2023-11-08T11:55:45","date_gmt":"2023-11-08T11:55:45","guid":{"rendered":"https:\/\/www.innov8fs.co.za\/blog\/?p=1508"},"modified":"2026-03-18T11:46:08","modified_gmt":"2026-03-18T11:46:08","slug":"big-nhi-surprises-ahead-for-south-africa","status":"publish","type":"post","link":"https:\/\/www.innov8fs.co.za\/blog\/2023\/11\/08\/big-nhi-surprises-ahead-for-south-africa\/","title":{"rendered":"Big NHI surprises ahead for South Africa"},"content":{"rendered":"

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The National Department of Health has responded to more concerns submitted in response to the National Healthcare Insurance (NHI) Bill \u2013 but has given no further clarity on what the system will cover or how the private sector will operate under it.<\/p>\n

This means that medical aids, private healthcare providers and South Africans at large are still in the dark \u2013 and will remain there \u2013\u00a0until the laws are passed and the department eventually reveals its full plans through regulations.<\/strong><\/p>\n

The National Assembly passed the NHI Bill in June 2023 and is currently with the National Council of Provinces (NCOP) for consideration.<\/p>\n

The bill has been closely scrutinised by various stakeholders in the healthcare sector, and concerns have been raised by medical schemes, insurers, doctors, and various others about the effect the Bill will have on their current businesses and general access to healthcare.<\/p>\n

Across all commentary, however, a massive problem with the bill keeps cropping up:\u00a0it lacks detail.<\/strong><\/p>\n

This has been acknowledged by the NCOP\u2019s select committee on health and social services, which noted this week that commenters are constantly seeking more detail about the NHI, especially around how the scheme will be funded, how medical aids and other private insurers will operate, and what exactly the scheme will cover.<\/p>\n

Commenters have explicitly stated that the lack of detail in the NHI Bill \u2013 especially around what services will be covered \u2013 is directly misleading the public because South Africans have no idea what they will actually get from the scheme.<\/p>\n

Unfortunately, for anyone seeking those answers, the NDOH has nothing to say.<\/p>\n

More specifically,\u00a0it does not yet know.<\/strong><\/p>\n

Surprise!<\/strong><\/p>\n

Responding to the latest round of questions, the department said that the NHI Bill is a framework that will enable the NHI Fund and other aspects of universal healthcare \u2013 and\u00a0all the details will come later<\/strong>\u00a0through regulations.<\/p>\n

\u201cThe NHI Bill provides a framework that requires regulations \u2013 not every single detail can be outlined and incorporated into a founding Act,\u201d it said.<\/p>\n

This means that the department doesn\u2019t know exactly how the scheme will be funded, as this is something that will have to be regulated later \u2013 once the laws have passed \u2013 in collaboration with the National Treasury.<\/p>\n

The department also cannot say what medical services will be covered by the NHI because, again, this is something that will only be determined later through regulations set by the health minister.<\/p>\n

\u201cThe NHI Bill outlines the framework that will apply in terms of the institutional and organisational structures for the (NHI) Fund. It also outlines the principle in terms of the health entitlements that will be covered, which are outlined as \u2018comprehensive\u2019 and covering the \u2018full continuum\u2019 of care.<\/p>\n

\u201cThe exact details of what will be covered cannot be outlined in the founding Act, but will rather be provided in the regulations. This is important to allow for flexibility around planning and proactively addressing population health needs as changes occur over time,\u201d the department said.<\/p>\n

What about private healthcare?<\/p>\n

The department argued that it\u2019s not stopping any economic activity or private healthcare providers from operating because they can do so outside the NHI system.<\/p>\n

However, unlike the private sector, the NHI will be exempt from all competition laws.<\/p>\n

\u201c(This) is based on the recognition that health is a public good that should not be left to the whims of the market,\u201d it said.<\/p>\n

The department also noted that the NHI Fund is not a procurement body but rather a \u201cstrategic purchaser\u201d. For example, the Fund will not procure health products on behalf of the private sector but will instead set prices for products that accredited providers can procure at.<\/p>\n

What does the department know?<\/strong><\/p>\n

In lieu of any details stakeholders actually want, the department has given some indication of what the scheme will entail.<\/p>\n