Who wins in the NHI healthcare system?

THE recently signed National Health Insurance (NHI) Bill is expected to provide universal healthcare coverage for all. But how universal will it be?

According to President

Cyril Ramaphosa, the ‘system seeks to ensure equal access to healthcare regardless of a person’s social and economic circumstances’.

He says under the NHI, ‘access to quality care will be determined by need, not by the ability to pay’. This will produce better health outcomes and prevent avoidable deaths.

Granted the signing does not automatically mean immediate implementation, but is the government dangling an unattainable ‘golden carrot’ in the faces of thousands of citizens, who have for years been beneficiaries of a flawed ‘public’ healthcare system?

Or is the public signing of the Bill a political ploy to garner votes in the upcoming elections?

For those who have been beneficiaries of State-run health facilities, the prospect of open access to private hospitals and clinics – reserved for the select few who are shielded by medical aid schemes – universal coverage is a reality we long to be part of.

It is the prospect of not having to travel long distances past privately-run facilities because you cannot afford medical aid to grant access to them.

It is the prospect of not having to play ‘musical chairs’ at the public health facilities from morning to noon just because you failed to be up at four in the morning to be first in line because unfortunately there is no appointment system.

But is the grass truly greener on the other side, especially for the working class who somehow always find themselves holding the shorter end of the stick - funding the government’s inadequacies?

Many have debated that the current state of the country’s economy begs the question of whether the government can run effectively a universal system that will not compromise the quality of healthcare for all.

The state of various government-owned and -run entities, including Eskom, does very little to build public or business confidence.

So, who funds this universal access? Will it be the already financially strained taxpayers or does the government have a fundraising ‘masterplan’ that does not involve falling deeper into debt or digging deeper into our pockets?

According to the president, NHI Fund is expected to procure services from public and private service providers to ensure all South Africans have access to quality healthcare.

It will be implemented in a phased approach, ‘with key milestones in each phase’, rather than an overnight event.

Whether this scheme will be realised in the near or distant future remains to be seen.

But one thing that many, including the business sector, organisations, political parties, economists and ordinary citizens are appealing for, is a clear funding strategy and effective implementation.