National Health Insurance in South Africa
Government Documents on Proposed National Health Insurance
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The ANC proposals were handed to the Department of Health for further development in late June 2009. There are no documents by Government in the public domain on the current NHI proposals under development. There are however references to the proposed timelines in several documents.
The previous Minister of Health, Barbara Hogan, prepared the document “Strategic Plan 2009/10 to 2011/12” (see http://www.doh.gov.za/docs/misc/stratplan/2009-2011/index.html). Priority 2 is the Implementation of National Health Insurance.
“(a) Finalisation of NHI Policies and implementation plans
Over the next MTEF period, the Department will continue to work towards the design of the National Health Insurance (NHI) system for South Africa that promotes health system integration and ensures universal access for all South Africans. The set targets are to produce a comprehensive policy document (White Paper) proposing a framework for an integrated NHI, as well as to publish the draft legislation (the NHI Bill) for public comment by March 2010.
(b) Implementation of Immediate implementation of steps to prepare for the introduction of the NHI (e.g. Budgeting, Initiation of the drafting of legislation)
The necessary institutional and organisational structure to start implementing NHI will be put in place by March 2010. This will be achieved in collaboration with all key stakeholders from within and outside government, particularly the stakeholders already involved in conducting technical work to facilitate the implementation of NHI. The key priority towards such implementation will be the strengthening of the public health sector.
In the meantime, to expand access to health care services in public hospitals and reduce the financial burden for the indigent, the Department will in 2009/10 develop policy proposals for the removal of user fees for specified patient groups in public facilities. The policy proposals will include the writing off of all medical debts of H1 and H2 patients. These proposals will be consulted with all stakeholders and policy makers in 2009/10 and will be implemented by 2011/12.”
The new Minister of Health, Dr Aaron Motsoaledi, has continued to focus on the Ten Point Plan. The most recent version, with more detailed information on the sub-projects for NHI, suggests that the NHI policy document will be released in November 2009 and a revised version, including public comment, will be ready for Cabinet by April 2010.
(see http://www.doh.gov.za/docs/misc/tenpointplan09.pdf ).
The Government Gazette GG32564 of 11th September announced the formation of the National Health Insurance Advisory Committee. It will advise the Minister of Health on the development of policy and legislation relating to the introduction of NHI. It provides for the appointment of a committee, its terms of reference and for remuneration of committee members.
http://www.greengazette.co.za/docs/2009/09/Gazettes/National/20090911%20-%20National%20Gazette%20No%2032564%20of%2011-Sep-2009,%20Volume%20531.pdf
The Minister in The Presidency for National Planning, Trevor Manuel, released a Green Paper on National Strategic Planning (see http://www.info.gov.za/issues/planning_performance/index.htm ). It has been suggested in media interviews that extensive reform like NHI will need to be considered as part of this strategic planning process.
Andrew Donaldson, deputy Director-General Public Finance, spoke at the BHF Conference on 31 August 2009 on “The economics of health system change: A public finance perspective”. Slides available at:
http://www.bhfglobal.com/bhf-conference-papers-and-presentations-2009-0
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