Funding for NHI a phased transition over next 15 years, says Health Dept

The heated debate around South Africa's proposed National Health Insurance (NHI) continues, as the Health Department drip feeds information to the public, and to Parliament.

The Department's funding plan for a phased transition to the NHI over a period of 15 years was presented in a briefing to the Standing Committee on Appropriations this week.

The Committee was probing funding mechanisms for the fund amid criticism that Parliament has not been circumspect enough about how this universal health care system will be paid for.

The Deputy Director-General responsible for the NHI, Dr Nicholas Crisp, said instead of rebates of around R34 billion a year for belonging to a medical aid, redirecting existing grants for health services to the NHI fund - and even introducing surcharges - are options under consideration.

But MPs have expressed reservations about introducing new taxes and surcharges – and whether the National Treasurywill agree to ringfence these to specifically fund the NHI.

Scrapping medical tax credits are among the Health Department’s proposals.

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From Dr Crisp's latest briefing, it appears that the wealthiest top third of medical scheme members would lose their tax credits over the next five years.

This is a change from the originally mooted category of above R1 million to now the top one third, comments Thoneshan Naidoo, CEO of the Health Funders Association.

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And the statement that the the NHI fund will be ramped up to R450 billion over the next 15 years, does not make rational sense, he says.

"Unfortunately, from what I've seen of the presentation, come 2040 or so, the budget is meant to reach R450 billion. These may seem like large numbers but keep in mind that today the combined healthcare expenditure (public and private) is just under R600 billion in 2025 terms - but what they're saying is in 2040 the combined budget is going to be R450 billion. It is not plausible."

Scroll up to the audio player to hear more from the Health Funders Association's Thoneshan Naidoo