Big business: NHI will repel medics

The government’s plan for universal health coverage as set out in the National Health Insurance (NHI) Bill will leave people worse off and deter globally mobile professionals from working in SA, Business Leadership SA CEO Busi Mavuso warned on Monday.

The government’s plan for universal health coverage as set out in the National Health Insurance (NHI) Bill will leave people worse off and deter globally mobile professionals from working in SA, Business Leadership SA (BLSA) CEO Busi Mavuso warned on Monday

Parliament’s portfolio committee on health approved the bill last month, and the National Assembly is expected to pass it within a few weeks.

The bill paves the way for establishing a single NHI fund that will purchase services from public and private sector providers for citizens, and cuts back the role of medical schemes to the point where they will be allowed to offer cover for services not provided by NHI. It has been criticised by the private sector, including SA’s biggest doctor organisations, private hospitals and SA’s biggest medical scheme administrator, Discovery Health.

Mavuso said in her weekly newsletter that the bill would throttle the private healthcare sector. “By forcing the private sector out of the provision of all but a limited set of complementary services, private provision would effectively cease. For globally mobile businesspeople and their families, this would be another serious disincentive to work in SA.

“To be clear, business would benefit from an environment in which everyone had good quality healthcare.” Not having good quality healthcare would be “catastrophic”, she said.

TO BE CLEAR, BUSINESS WOULD BENEFIT FROM AN ENVIRONMENT IN WHICH EVERYONE HAD GOOD QUALITY HEALTHCARE

It appeared that nothing had been learnt from “other critical interventions that government and business have achieved by working together. The electricity crisis is an obvious example, where the introduction of largescale private electricity generation has led to a dramatic increase in the number of projects now being built to add capacity to the grid,” she said.

The private sector could complement government efforts, speed up investments, and reduce costs, she said, citing the Covid-19 pandemic.

Business worked closely with the government to source equipment and medicines, and to expand provision of vaccines rapidly around the country. “It was a clear demonstration that national health outcomes are achieved faster and more efficiently when government and business work together, drawing on their respective strengths,” said Mavuso.

Many other countries had effective universal health coverage systems based on a multifunder model, she said, urging the government to reconsider the role of medical schemes under NHI. Brazil and Thailand were among developing countries that provided health services with a blend of private and public cover, she said.

Last week, the Hospital Association of SA (Hasa), which represents SA’s biggest private hospital players, urged the National Council of Provinces (NCOP) to heed the concern expressed by stakeholders during the public hearings held by the portfolio committee on health.

Hasa called on the NCOP to insist on a multipayer model to militate against the concentration of risk posed by the bill’s single-payer system, ensure there was an iterative rollout based on milestones rather than dates, and step up the bill’s governance provisions to ensure the NHI fund was not left open to theft and corruption.