The industry body says the dwindling number of medical aid members means the government must act.
South Africa’s healthcare system is not merely unviable or unsustainable, “it is at the brink of collapse” if the government does not intervene, says the Board of Healthcare Funders, which represents most medical aid schemes in the country.
“People are paying contributions to their medical schemes that are higher than inflation,” Humphrey Zokufa, who heads the board, said on Tuesday at a media briefing in Johannesburg.
He said that people have to pay copayments and their benefits run out. In addition, the pool of insured people is not increasing and those who are insured are ageing.
“In a situation like this, government has no option but to intervene, and that intervention is taking the form of the National Health Insurance [NHI].”
The NHI is a plan for significant reforms to the public and private health sectors and aims to make affordable healthcare available to all South Africans by pooling money from various sources, such as the Road Accident Fund, into a single NHI fund.
But the NHI has been severely criticised from various sectors, including the Free Market Foundation, which called it “unaffordable and ill conceived”, and an “impending disaster”.
Health Minister Aaron Motsoaledi dismissed these claims as mere “scare tactics” designed to make people fearful.
“History has shown that pooling money into a single fund does not increase expenses for individuals; it reduces them,” he said at the media briefing.
According to Motsoaledi, government was able to reduce the individual cost of antiretroviral medication from R10 000 a patient a year in 2002 to the current cost of R1 700 a patient a year by pooling funds. In the same way, he said, the department has been able to negotiate for lower vaccine prices.
“Since we introduced the human papillomavirus vaccine at schools in 2014 we have vaccinated 700 000 school girls. The cost of the vaccine then was R2 000 for the two doses needed, so it would have cost us R1.4-billion. But because we pooled the funds in the same way we envision under the NHI we are only paying R200-million a year,” said Motsoaledi.
The NHI white paper, which was released for public comment in December last year, received mixed reactions with many questioning the lack of details about how the scheme will be funded.
But Zokufa argued that the negative comments about the NHI could possibly be “fuelled by narrow self-interests or by those not really looking to improve the system for all South Africans”.