Doctors, nurses, dentists and hospitals will treat everyone when National Health Insurance (NHI) is rolled out, selecting them on the basis of how sick they are, rather than on their ability to pay, says health minister Dr Zweli Mkhize.
On Friday morning, Mkhize gave parliament more details on how NHI would work.
Cabinet approved the NHI bill on Thursday, moving it to parliament for debate.
In its draft form in 2018, the bill suggested NHI would be a single government-run medical fund, financing health services for rich and poor, and reporting to the minister of health.
It is not clear what changes have been made to the bill by government since last year.
Mkhize said on Friday that under NHI, healthcare would be the same for everyone, private and public, saying health workers “will be available to provide services equally”.
“Currently, poor people often get second-rate healthcare, while wealthier people are able to afford good treatment. The power lies in our hands … NHI is a way of providing good healthcare to all our people.”
Experts and companies have questioned how NHI would be funded. Estimates of the annual cost have ranged between R259bn and R350bn.
Mkhize did not explain where the money would come from, but said NHI would be the answer to current funds shortages in the health system.
“In the long-term, the investment in NHI will create a funding mechanism that will permanently resolve underfunding.”
Mkhize said at present there was insufficient funding allocated for the health system. “The current baseline [of funding] is below the expected level of funding, considering the population size, disease burden and the expected quality of services required.”
“We are engaging National Treasury to explore various modalities to adequately fund health services.”
He admitted that the R19bn allocated for the next three years for dilapidated and decaying infrastructure was “grossly inadequate”.
Babies would be registered on the NHI computer system when they were born, and also registered at Home Affairs, the minister said.
The health department was working with treasury to find funds to ensure vacant doctors and nurses posts were filled, he said.
He also committed to increasing the use of community health workers by government. These people provide nursing support services by visiting patients at home to track why they missed appointments to fetch medicines or find sick people who need referral to a clinic.
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