While congratulating Health Minister Dr Zweli Mkhize on the introduction of the NHI Bill and government’s commitment to implementing a system of universal healthcare, the Health Funders Association (HFA) has added its voice to calls for clarity on the role of medical schemes.
A comparatively new health sector player, the HFA – a representative organisation for medical schemes, administrators and managed care organisations – already has a membership comprising 53% of medical scheme members across open and restricted schemes. These are made up of 76% from open schemes, 21% of restricted schemes, and covering more than 4.4m medical scheme beneficiaries.
Point made by HFA CEO Lerato Mosiah on the NHI Bill is that the scheme industry in its current form can play a considerable administrative and operational contributory role to the funding mechanisms proposed.
“The private healthcare funding industry is a national asset with a technologically advanced infrastructure and experience in the delivery of efficient administration, timely pay-outs, holistic benefit design and good governance,” she said.
“We believe that this asset could and should be leveraged both during the implementation of NHI and once the system is up and running”, she added.
This view, said Mosiah, was supported by the fact that the principles contained in the NHI Bill and the Medical Schemes Act “mirror one another”: “Both the NHI Bill and the Medical Schemes Act have, at their core, principles which ensure access and equity which advance the values of social solidarity and protection. These include a set of guaranteed benefits, open enrolment and cross subsidisation between the rich and poor, and the sick and healthy.”
added, therefore, that while her organisation was
still studying the detail of the Bill, there were several high-level areas –
not least the role of medical schemes – where
greater clarity was required and that she hoped to address these with the
She concluded, nonetheless, by reiterating that the HFA has committed its willingness to support and assist government in establishing the mechanisms necessary to achieve a sustainable system of universal healthcare provision and funding.
SOURCE: Health Funders Association of SA; email@example.com