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How will NHI affect healthcare in South Africa?

In August last year, South African parliament released the new National Health Insurance (NHI) Bill. This new bill will only be fully implemented by 2026 and is set to have a serious impact on healthcare in South Africa.

The NHI bill explained

“South Africa is facing numerous challenges when it comes to healthcare costs and services. The country spends huge amounts of money for health care on very few people. Many health care professionals only serve a few people who have money and the rest of the public is serviced by very few professionals. Access to health is a right according to our Constitution.

The Government through the National Department of Health has realized that it is time for the country to move to universal health coverage where everyone receives quality healthcare regardless of his or her economic status.”

– The South African Department of Health

In a nutshell, the new NHI bill is government-issued legislature that was created as a result of the aforementioned healthcare considerations. The bill will regulate a system of national health insurance that offers quality and affordable healthcare to all South African residents.

This is essentially a health financing system that is designed to pool funds together to provide universal healthcare. This will be achieved predominantly through taxpayers. Most healthcare, including doctors’ visits, medication, operations and hospital stays will become free for everyone.

In comparison to the previous South African healthcare system, The South African Department of Health defines two key differences with the new NHI Bill:

  1. This health insurance will cover every South African, employed or unemployed, earning low income or high income. 
  2. The socio-economic status of members of the public will not influence the type of healthcare you receive but it will be influenced by the condition of your health. There will be no limited benefits because of the salary you earn or because you are unemployed.

When fully implemented, the NHI will naturally have a big effect on all the current medical aid or health insurance schemes that you may be familiar with.

Effects of the NHI on private hospitals and medical aid schemes

1. Comprehensive medical aid will fall away

Once implemented, medical schemes won’t be able to offer any health services already offered by the NHI. Medical aid will only offer you extra services not covered by the NHI.

2. The NHI will offer comprehensive health care service cover

South African’s will use their free NHI cover for a wide variety of healthcare needs, instead of medical schemes. An appointed committee is currently still defining exactly what these benefits will be. There will be no co-payments.

3. The private sector will still have a role to play

Minister of Health, Dr Zweli Mkhize has stated that private practices, pharmacies and hospitals will not be nationalised under the NHI. South Africans will still be able to register for their preferred health provider.

It’s clear that there is a lot to understand about the NHI. The good news is that there is still time to familiarise yourself with the with this new system and to prepare yourself for the impacts.