EXPLAINER: What you need to know about NHI
The National Health Insurance Act has been signed into law. But what is it and how will it work? This is what you need to know about NHI.
President Cyril Ramaphosa poses after signing the National Health Insurance Bill into law at the Union Buildings in Pretoria on 15 May 2024. Picture: Picture: GCIS
JOHANNESBURG - Government first mooted the National Health Insurance (NHI) back in 2011. But it’s now become an act of law. Its intention? To provide universal healthcare to all South Africans.
So, how will this be realised?
The first step will be to create the NHI fund, which will operate like a business, to buy services for all South Africans from both the public and private sector. This fund could take at least a year to establish.
Where will the money come from?
The NHI Act proposes increased tax collection to be determined by National Treasury. This could be in the form of a payroll tax - much like the UIF - and an increase in personal taxes.
Who is eligible for NHI?
The idea is for all South Africans, permanent residents, refugees and some categories of foreign nationals, to receive treatment at a facility closest to where they live, whether this is a public or private institution, if they have a contract with the NHI.
The NHI will pay the supplier directly for the service you receive.
What will happen to private medical aid schemes?
Once the NHI covers a benefit, medical aid schemes may not cover the same service. In time, it will mean the benefits they cover will be dramatically reduced, their membership will dwindle, and they may not be able to survive to only offer additional benefits not covered by the NHI.
Will you still be able to visit a private doctor?
Yes you will - but you will have to pay for their services in cash, and you won’t be able to use your medical aim scheme to pay for a service already provided by the NHI.
Why are some sectors arguing the NHI is unconstitutional?
Many believe while the concept is noble, the NHI model, in its current form, is unaffordable and will limit your choice of the healthcare you receive. The private sector argues it will stifle competition by blocking it from offering services also offered by the NHI, while the medical fraternity says it’s forcing doctors to work for the state.
How long will the rollout take?
Health Minister Joe Phaahla estimates the first phases of the NHI will take at least four years, with the full implementation expected by 2030.