The Council for Medial Aid Schemes (CMS) is looking for comment on the prescribed minimum benefits. This links to South Africas National Health Insurance as well as Universal Health Coverage in its outcomes. CMS are calling for comment and it should not be forgotten that patients should be involved in this process. As it affects them the patients in the outcomes of this process.
Section 6 listed below.
The Department of Health of South Africa has extended the deadline for comment to May 31 2016 on White Paper on National Health Insurance for South Africa.
Please submit comments to [email protected] which will be sent to the Director-General. Please note no submission after the deadline will be accepted.
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The 97-page paper outlines the country’s path to universal health coverage over 14 years and proposes dramatic changes in the role of private medical aids and the National Health Laboratory Services among others.
Projected NHI funding shortfalls under different growth paths.Click to enlarge graph
Released on 10 December, the long awaited white paper begins by providing the background and justification of the country’s moves to join other countries like the Brazil, the United Kingdom and Thailand in introducing universal healthcare coverage.
The document notes that healthcare in South Africa is comprised of a two-tiered system divided along socio-economic lines. The private medical aid sector is comprised of 83 medical aid schemes that fund healthcare services for about 16 percent of the population. The paper noted that spending through medical schemes in South Africa is the highest in the world and is six times higher than in Organisation for Economic Co-operation and Development (OECD) countries
The paper argues that this two-tiered system has led to fragmented funding and risk pools in healthcare and posits that the creation of a National Health Insurance (NHI) will improve healthcare equity by combining fragmented private and public health funding pools and eliminating out-of-pocket payments.
The notes that the NHI will ultimately deliver a comprehensive package of health services that include services such as rehabilitation and palliative care, mental health care including that related to substance abuse and maternal and child health care.
The document then goes onto describe the NHI’s implementation during a 14-year period. The first five-year period will focus on strengthening of the service delivery platform and the overall improvement of quality in the public health sector. A second, five-year phase will feature the roll out of a NHI card to all South Africans and permanent residents.
Foreign nationals and students with or without visas and temporary residents will be required to have private medical insurance. The document notes that a special contingency fund will be established to provide basic health coverage for refugees while asylum seekers will be guaranteed access to care in case of emergency and for notifiable conditions of public health concern.
Potential revenue sources for the NHI. Click to enlarge graph
This phase will also see the introduction of long-awaited unique identifiers linked to the Department of Home Affairs and the creation of a transitional fund to purchase primary health care services from certified public and private providers. User fees in the form of direct out-of-pocket payments in public hospitals will be abolished to improve access to needed health services and to protect households from financial hardships.
The document notes that ultimately private medical aids may supply “top up” services over and above a basic package of services that has yet to be defined. It also notes that given recent problems in funding the National Health Laboratory Service (NHLS), a new NHLS funding model will have to be developed.
The third and final phase of implementation will take place over the last four years and will focus on ensuring that the NHI Fund is fully functional. Administered by a the NHI Commission comprised of a diverse range of national experts, the fund will be charged with:
The document concludes with a discussion of possible methods to finance this fund such as changes in payroll or value-added taxes. The white paper admits that the NHI’s financing requirements are uncertain, and in part depend on public health system improvements and medical scheme regulatory reforms which have not yet been fully articulated.
File Download: National-Insurance-White-Paper-December-11-2015
All credits to Article Health-e News
The 97-page paper outlines the country’s path to universal health coverage over 14 years and proposes dramatic changes in the role of private medical aids and the National Health Laboratory Services among others.
Projected NHI funding shortfalls under different growth paths.Click to enlarge graph
Released on 10 December, the long awaited white paper begins by providing the background and justification of the country’s moves to join other countries like the Brazil, the United Kingdom and Thailand in introducing universal healthcare coverage.
The document notes that healthcare in South Africa is comprised of a two-tiered system divided along socio-economic lines. The private medical aid sector is comprised of 83 medical aid schemes that fund healthcare services for about 16 percent of the population. The paper noted that spending through medical schemes in South Africa is the highest in the world and is six times higher than in Organisation for Economic Co-operation and Development (OECD) countries
The paper argues that this two-tiered system has led to fragmented funding and risk pools in healthcare and posits that the creation of a National Health Insurance (NHI) will improve healthcare equity by combining fragmented private and public health funding pools and eliminating out-of-pocket payments.
The notes that the NHI will ultimately deliver a comprehensive package of health services that include services such as rehabilitation and palliative care, mental health care including that related to substance abuse and maternal and child health care.
The document then goes onto describe the NHI’s implementation during a 14-year period. The first five-year period will focus on strengthening of the service delivery platform and the overall improvement of quality in the public health sector. A second, five-year phase will feature the roll out of a NHI card to all South Africans and permanent residents.
Foreign nationals and students with or without visas and temporary residents will be required to have private medical insurance. The document notes that a special contingency fund will be established to provide basic health coverage for refugees while asylum seekers will be guaranteed access to care in case of emergency and for notifiable conditions of public health concern.
Potential revenue sources for the NHI. Click to enlarge graph
This phase will also see the introduction of long-awaited unique identifiers linked to the Department of Home Affairs and the creation of a transitional fund to purchase primary health care services from certified public and private providers. User fees in the form of direct out-of-pocket payments in public hospitals will be abolished to improve access to needed health services and to protect households from financial hardships.
The document notes that ultimately private medical aids may supply “top up” services over and above a basic package of services that has yet to be defined. It also notes that given recent problems in funding the National Health Laboratory Service (NHLS), a new NHLS funding model will have to be developed.
The third and final phase of implementation will take place over the last four years and will focus on ensuring that the NHI Fund is fully functional. Administered by a the NHI Commission comprised of a diverse range of national experts, the fund will be charged with:
The document concludes with a discussion of possible methods to finance this fund such as changes in payroll or value-added taxes. The white paper admits that the NHI’s financing requirements are uncertain, and in part depend on public health system improvements and medical scheme regulatory reforms which have not yet been fully articulated.
File Download: National-Insurance-White-Paper-December-11-2015
Health-e News September 28, 2015
Agenda 2030 SDGs -Sustainable Development Goals
For the next 15 years, the newly adopted Sustainable Development Goals (SDGs) will guide what donors fund and what countries push – and the world may just take a page from Africa’s playbook as it pursue universal health coverage.
Born in Springs on Johannesburg’s East Rand, Matshidiso Moeti grew up watching her doctor parents tend wounds and set bones in nearby KwaThema. The little girl destined for big things learned early that injustice and inequity were their own sorts of plagues. “My parents were doctors in the township and ran a practice…so one was aware of the struggles of families in the community,” she said. “Even by the time I was 7 or 8 years
old, I remember reading The Post newspaper and being very much aware of the political system in place, aware of what was essentially an unjust society… this influenced me a lot.” When Moeti’s parents moved to Botswana, her father took to the bush conducting small pox eradication campaigns. Her mother took a post at the Botswana Ministry of Health, which led her to what is now Kazakhstan for a work meeting in 1978. When Moeti’s mother returned home, she had been a part of history. Her meeting had adopted the Alma-Ata Declaration, which made the case for universal health coverage. It would also shape her daughter’s destiny.
Universal health coverage is one of the 169 targets and 17 goals comprising the SDGs adopted by the United Nations on Friday 25 September. They take over from the eight Millennium Development Goals adopted 15 years ago. The product of hard 
negotiations and almost 100 international consultations, the SDGs are sufficiently vague to read like a Utopian laundry list. The real meat likely to guide governments’ and donors’ money is hidden in the SDG’s targets, which include the roll out of universal health coverage (UHC).
But what the world committed to in New York this weekend, Africa has been slowly mulling over for the last decade as more countries including South Africa turn to UHC as a way of improving health outcomes and stamping out deadly inequalities. From Nigeria to Rwanda, African countries are carving out new ways of dolling out – and paying for – healthcare. (more…)