How will NHI affect med aids? Stop asking me hard questions, replies Mkhize
Health minister is a little vague on the details when grilled about how his scheme will work
A briefing by Health Minister Zweli Mkhize on Friday shed little light on how private medical aids would coexist with the proposed National Health Insurance (NHI).
Mkhize became visibly frustrated when journalists asked question after question about medical aids at his media briefing about NHI pilot projects. He complained that he had “six questions” on the topic that were not what “we are here to talk about”, and suggested the private medical aid industry was lobbying the media to say negative things about NHI.
“Let’s try and separate the issue of medical aid [from NHI]… we are not going to be bogged down on one issue … by medical aids. Their roles will be evolving,” said Mkhize.
In explaining how NHI would work, he said NHI and the doctors would determine who received medical care first, based on a patient’s need for a specialist doctor – and not on their wealth.
We will change the way medical aids work.Health Minister Zweli Mkhize
Asked whether South Africans would be expected to pay money into an NHI fund and pay tax, before being allowed to join a private medical aid, Mkhize said “employers and employees” would pay for the NHI fund. The state would then use that money to buy health care for all South Africans.
“We will change the way medical aids work,” he added, suggesting medical aids could cover costs that NHI wouldn’t.
“Then people are still free to pay for schemes that will cover something is not available on NHI insurance.”
He said academic heads of hospitals were currently deciding what services NHI would provide.
Asked if medical aids’ role would change, he said he could not answer questions “today” on “what will happen in 30 years’ time”.
He said the idea of an NHI fund as a single centralised fund to buy health care was based on the principle of “social solidarity”, with the rich paying for the poor and healthy paying for the sick.
A reporter pointed out the current medical aid system was already based on the principle of the healthy subsidising the sick, to which he replied: “Where did you get your information?”
He said NHI would ensure the sickest people received health care first.
“It’s not everyone who wishes to see a specialist who should actually see a specialist. It is not my right to see a specialist because I can afford it. It is a distortion of how the system should be working ...
“The fact that you have a medical aid and can order an MRI and can be paid for is a distortion.”
He said he would not “protect private business interests” at the expense of “protecting the interests of the majority”.
He said medical aids had their own problems that needed to be discussed.
“Many of you who have medical aids know that come June and July you must go to a public hospital [because funds have run out].
“One medical aid has between 3 and 3.5 million members. Is this good for competition? The system has issues. We must debate this going forward.”
Mkhize pointed out that “many healthcare practitioners won’t claim from medical aids”, demanding cash instead.
But he acknowledged both the quality and management of state health care needed to be improved.
“Public health has been underfunded,” he concluded.