Media Briefing NHI Pie in the Sky

Dr Johann Serfontein & Jasson Urbach
19 July 2017
11h00 for 11h30 Registration & finger lunch
11h30 to 13h30 Presentation & discussion
FMF, Block 5 Bryanston Gate, 170 Curzon Road, Bryanston (Off Main Road opposite the Sandton Medi-Clinic)

Speakers Dr Johann Serfontein, a senior healthcare consultant with HealthMan & Member of the FMF’s Health Policy Unit & Jasson Urbach, FMF Director & Head of the FMF’s Health Policy Unit

 The latest iteration of the national health insurance (NHI) policy paper was published on 28 June 2017. It’s déjà vu all over again. We are no closer to understanding critical details, such as how much the scheme will cost and where the money to pay for it will come from.


The deadline for public comment is still to be announced but, despite economic alarm bells ringing throughout the economy, government is going ahead with the scheme in an increasingly authoritarian attempt to limit our civil liberties and freedoms.


As the FMF has repeatedly said the consequences of adopting a single payer model of healthcare that is centrally administered are entirely predictable. The NHI proposals will:


  • Reduce the quality of South African healthcare provision
  • Reduce the range of healthcare services available to all users
  • Drive more healthcare professionals out of the country
  • Create a bureaucracy entirely incapable of handling the huge volume of claims
  • Impose an unnecessary and intolerable burden on taxpayers and government

“Free healthcare for all” is a disastrous use of scarce taxpayer resources. Those who can pay for their own healthcare and, generally, do not rely on government provided service, must be allowed to continue to do so. Government’s role should be to fund the healthcare needs of only the poorest and most vulnerable members of society.

While payment into the central NHI fund will be compulsory, access to the NHI services will be voluntary. Medical schemes, however, will not be able to cover services included in the NHI basket of care. Those choosing not to use NHI services, will thus only have access to health services on a cash basis.

In the absence of a costing model, early indications are that the basket of available services will be adapted to fit into the available tax funded budget. What levels of availability of funded services will still be considered universal, in a setup where the budget determines which services are available on an ongoing basis? If only limited services can be afforded in the NHI budget, what happens to patients that currently have access to a larger range of services in both the public sector and through medical scheme access?

History has demonstrated that once a law is enacted, it is very difficult to repeal. The public sector is in shambles. South Africa should not be trying to expand and emulate the failed policies that led to this situation.

Government should be concentrating scarce taxpayer resources on the poor and destitute, and allowing the private healthcare sector to grow, innovate and expand. Such a healthcare model would not only be good for South Africa’s financial health, but would lead to better health outcomes for the poor, which is surely what we all want.

Understanding what is proposed is worth 60 minutes of your time.

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