President Cyril Ramaphosa will publicly sign the National Health Insurance (NHI) Bill into law on Wednesday, 15 May 2024.
The signing ceremony will take place at 14:00 at the Union Buildings in Pretoria.
The NHI Bill, which received approval from both the National Assembly (NA) and the National Council of Provinces (NCOP) last year, will provide free healthcare for all South Africans, regardless of whether they seek medical assistance from public or private health facilities.
The National Health Insurance (NHI) operates as a Fund financed by taxes, through which the government purchases healthcare services for all residents of the country from both public and private healthcare providers. This ensures that when individuals require medical attention, they can visit their preferred GP or clinic with a contract with the NHI, without concerns about the cost of care.
Contributions to the NHI Fund will be collected through prepayment methods like taxes. Once enrolled, individuals will have their healthcare services paid for directly by the Fund, eliminating the need for patients to pay at the point of care. This approach aims to remove financial barriers to accessing healthcare, ensuring that all citizens can receive the medical attention they need without worrying about affordability.
Key provisions of the NHI Bill include the establishment of a National Health Insurance Fund to oversee the procurement of healthcare services for all registered users. The bill also outlines measures to ensure equitable and efficient resource utilization, remove barriers to access, and prevent undesirable practices related to healthcare funding.
In addition to granting universal access to healthcare services, the NHI seeks to enhance service quality, alleviate disease burdens, and offer financial risk protection to individuals. It is viewed as a crucial step toward fostering economic development and growth, as a healthy population contributes to a more productive workforce and overall economic stability.
Moreover, the NHI Bill reflects a broader vision of promoting social cohesion and equity within the healthcare system, fostering a society that prioritizes compassion and inclusivity across all socio-economic strata.
What is the NHI and how will it change the system?
- The NHI is a Fund, paid by our taxes, from which the government will buy health care services for all of us who live in the country from health care providers in the public sector and private sector.
- This means when you feel unwell, you can go to your nearest GP or clinic of your choice that has a contract with NHI and not worry about the cost of care.
Why do we need NHI? What are the benefits of NHI?
- Providing health care for all: South Africa is a member of the United Nations community and we have committed that we will implement universal health coverage for all. We believe access to healthcare is a fundamental right for all. The government has the legislative mandate to realize this right. And the government has the responsibility to implement universal health coverage to ensure that all people are able to access health care when and where they need it without suffering financial hardship.
- Improving quality of services: The public sector has constraint budgets that are not sufficient to provide health care services for the 84% of the population that relies on public sector for health care. This results in an overburdened public sector that is characterised by underservicing. The private sector, that serves 14% of the population, is characterised by rising costs of care and overservicing without demonstrating much improvement on health outcomes. Both sectors need a reform to ensure that quality of health is improved. The pooling of funds into one fund will improve quality of services and therefore improve health outcomes.
- Reducing burden of disease: Extending health coverage for all South Africans will improve access to care, quality of care and continuity of care. NHI reforms will contribute to the health system having a co-ordinated and well-structured response to burden of disease.
- Financial risk protection: The NHI Fund will protect individuals from financial hardship when they need to access healthcare services. Financial hardships take place when you need to pay out-of-pocket payments such as user fees at facilities and co-payments for individuals insured by medical schemes. Contribution to the Fund will be through prepayment methods such as taxes. Services will be paid for by the Fund and the patient will not have to pay at the point of care.
- Economic development and growth: A healthy population can work more effectively and efficiently and contributes to economic growth. A productive workforce contributes to the economy through growth of local business, attracting foreign investors and growing the domestic economy. An investment in health is an important safety net against poverty by providing financial protection for everyone.
- Integration of the healthcare system: The fragmented, two-tiered system undermines principles of equity and social solidarity and leads to a health system where resources are distributed unfairly. The NHI will promote equitable access to care, and this will be achieved by cross-subsidisation among the population. The NHI fosters social cohesion and contributes to developing a society that is compassionate across all socio-economic groups.
What is the significance of passing the Bill?
- Government considers the passing of the NHI Bill by the National Assembly as a key milestone to ensuring all people in SA have access to a clinic, a doctor or a hospital (public or private) closer to where they live or work without paying when they need the services. We will have paid in taxes already so the government will pay the provider of your care for you and your loved ones. There will be no gap cover for you to fund and no cash out of pocket payments.
- Government recognises the efforts by all stakeholders which exercised their constitutional rights to participate in legislative processes to influence decision-making process of the NHI Bill.
- The Department will remain available and accessible at all times to clarify any ambiguities and public concerns about the Bill and its objectives.
Who will be covered under the NHI Fund?
- The fund will purchase services on behalf of SA citizens, permanent residents, refugees, inmates and specific categories of foreign nationals.
- Asylum seekers and illegal foreigners will be covered for notifiable conditions and emergency medical services.
- All children will be covered for all benefits purchased by the fund regardless of nationality.
- Visiting foreign nationals will be covered by their mandatory travel insurance.
Will unemployed people be able to access health care services?
- Yes. The NHI Fund will purchase services on behalf of all South Africans. All users will be able to access health care services without paying anything at the point of care, regardless of their socioeconomic status.
How much will it cost to receive services at a clinic, GP or hospital?
- The NHI Fund will pay the clinic, GP or hospital. You will not pay anything when receiving care.
- This is to make sure that everyone is able to receive health care services when they are sick, at a facility close to them (as long as the facility has a contract with the NHI Fund).
How can I register and what do I need for registration?
- You will register with the NHI Fund when you go to a clinic, GP or hospital that has a contract with the NHI for the first time. You will not need to register again when you go to any other clinic, GP or hospital because the NHI system will make sure that your records are available at every contracted health care provider.
- There is no fee payable for registration. This will be a similar process that you currently do each time to you go to a clinic, GP or hospital.
- You will need your ID book, passport, or other identity document to register. Your fingerprints will be taken and put on the NHI Fund system. This will make it easy when you visit the clinic, GP or hospital again, or when your ID is lost. Fingerprints are a way to prevent fraud and identity theft but mostly to be absolutely sure that the medicines that you are given are for you and not someone else.
- Each time you attend a clinic, GP or hospital you will need to present your proof of identity. If you are unconscious, then the provider can still find your records using your fingerprints.
Will individuals be able to use facilities of their choice?
- Yes. The NHI aims to make health care more accessible to all South Africans. Individuals will be able to access NHI-contracted GPs, clinics or hospitals closest to them, whether in the public or private sectors.
How will South Africans who do not have IDs be helped?
- Biometric identification will be used in facilities under the NHI reform. This is to ensure that all users have a portable health record that can be accessed under all circumstances anywhere in the country.
- The department of Health has a collaboration with Department of Home Affairs to address birth and death records.
- This collaboration helped many undocumented South Africans to access COVID-19 vaccinations during the COVID-19 pandemic.
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