National Health Insurance
The National Health Insurance (NHI) initiative has been widely discussed in both the media and government, and while there is agreement that healthcare for all citizens is something that should be brought about as soon as humanly possible, there is still a large number of people debating whether or not it is being done in the correct manner.
In the early months of 2012, the South African government, in association with the Department of Health, began rolling out the pilot development program for the NHI, which would initially see 10 pre-selected pilot sites being given an additional amount in order to improve various departments and sectors. This rollout was meant to be the beginning of a massive comprehensive reform of the public health system in the country.
However, each of these sites was only provided with an estimated R11 million to perform the necessary development. This amount is only a fraction of what it may cost each of these areas to improve health services such as infrastructure, staff training, awareness campaigns, research, school-level health programs and district-specific interventions.
While the outcome of the initiative would prove greatly beneficial, if implemented correctly, and will provide comprehensive healthcare to individuals regardless of employment or social circumstance, the current level of improvement might mean that the public would end up paying an extra insurance bill to the government for healthcare that remains ranked below Cuba in terms of quality of return on investment.
The payment factor of this Insurance fund is what worries most people, and the general concern is that individuals in the lower income brackets would be made to pay for these services, regardless of whether they choose to make use of them. The proposed funding through tax increases and increases on Value Added Tax on certain consumer goods means that more pressure is placed on lower-income households than on those in higher brackets.
While in other countries, the contribution to health care from the GDP makes up around 70%, but the statistics in South Africa show that it stands at about 40%. This means that around 60% of the funding is made up from private sector contributions and patient payments.
All in all, the NHI is a great idea that will help to aid the development of healthcare and overall welfare in the country. However, the current version of the proposed Green Paper is very vague on some important issues.
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