Health-e (Cape Town)

South Africa: NHI Presented to ANC

Anso Thom

2 June 2009


An ANC task team charged with developing a National Health Insurance (NHI) plan for the country if due to present its proposal to the party this weekend.

Stakeholders and experts have expressed concern that the task team headed by Human Sciences Research Council CEO, Dr Olive Shisana and heavily laden with trade unionists, is trying to convince the ANC and government to hastily implement an NHI plan that many believe spells disaster for the buckling public health system.

The NHI was a key ANC election promise and the party promised to implement it within five years despite the current economic downturn that has brought massive job losses.

There is agreement among all stakeholders that inequities in the health system, which has resulted in the private sector monopolising resources disproportionately, need to be addressed. However, they warn that this must be done in a manner that does not destroy the functioning private sector and cause more skilled health professionals to leave the country.

It is widely accepted that former health minister Barbara Hogan's insistence that the current NHI proposal be subjected to proper processes and public scrutiny led to pressure from the unions that she be removed from the health portfolio.

The health department failed to comment yesterday, but newly installed health minister Aaron Motsoaledi said at his first press briefing last month that there were enough resources for the continued existence of the public and private health care sectors, but that the funding allocation between these areas was "skewed".

"We think there is something grossly wrong with that. We need to use the resources available," he said.

Shisana confirmed yesterday that the task team has been working on the NHI plan since last year.

"It is a complex exercise. All the work done is based on scientific evidence generated domestically and internationally and once the plan is completed, the public will be given an opportunity to make input before it is finalised," she said.

Nonkosi Khumalo, chairperson of the Treatment Action Campaign said there was recognition that the resolution of the crisis in public health care is one of a number of key steps integral to laying the groundwork for the introduction of NHI.

However, she added that universal access to health care - a defining feature of NHI - cannot be achieved without appropriate regulation of the private sector.

A confidential draft of the NHI plan indicates on its front page that "This project was funded by the Bill and Melinda Gates Foundation". However, the foundation said it did not fund political parties.

"The Gates Foundation funded the Human Sciences Research Council to conduct research for the purpose of developing recommendations and policy options regarding health priorities, including health insurance. The foundation does not fund political parties," said Gates spokesperson Deborah Lacy.

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