National Health Insurance -What the future holds?

Department of health defines The National Health Insurance (NHI) as a financing system that will make sure that all citizens of South Africa (and legal long-term residents) are provided with essential healthcare, regardless of their employment status and ability to make a direct monetary contribution to the NHI Fund.


Why does South Africa need national health insurance?
Healthcare is a human right – this is a widely accepted international principle. This right should not depend on how rich we are or where we happen to live. The right to obtain healthcare is written into our Constitution.
But large numbers of our people continue to die prematurely and to suffer unnecessarily from poor health. Treatable conditions are not being treated on time and preventable diseases are not being prevented.
This is in spite of the fact that government has tried its utmost since 1994 to ensure that everyone in this country has equitable access to necessary healthcare services. There are still serious challenges mainly caused by a skewed healthcare financing system. Without NHI, the burden of disease in the country will not be reduced because the majority of the population – and the section suffering the greatest ill health – will not access good quality healthcare.
What healthcare services will be funded by NHI?
The NHI will offer all South Africans and legal residents access to a defined package of comprehensive health services. The state is committed to offering as wide a range of services as possible. Although the NHI service package will not include anything and everything, it will offer care at all levels, from primary health care, to specialised secondary care, and highly specialised tertiary and quaternary levels of care.
Examples of what the NHI package will exclude are:

• Cosmetic surgery that is not necessary or medically indicated but done as a matter of choice – for instance, botox, liposuction and face-lifts.
  
• Expensive dental procedures performed for aesthetic purposes.
  
• Expensive eye-care devices like trendy spectacle frames.
  
• Medicines not included in the National Essential Drug List except in circumstances where the complementary list has been approved by the Minister of Health.
  
• Diagnostic procedures outside the approved guidelines and protocols as advised by expert groups.
  

The benefits provided will cover preventive, promotive, curative and rehabilitative health services. It is important to note that emphasis will be placed on prevention of disease and promotion of health. The present healthcare system places undue focus on curing of disease and performance of procedures when people have developed complications.

My own point of view

I think this mentality of most people in my profession (Occupational therapy) should stop or else our career path will always be unknown and we will remain underpaid just because we are passive and submissive.The national health insurance was launched a long time and other professions such as Pharmacy are busy engaging it and we are on the back sit waiting to move with the flow. recently the congress of  Pharmacy students in South which was held in the University of North West discussed the issue at length and came up with resolutions leading to the Pharmacy congress in December this year.

I feel that as Occupational therapist ,both students and professionals should understand the role that we will play towards this initiative and to perhaps maybe figure out some innovative ways that we can apply in shaping our profession to fit it.

I believe that through discussions and engagement with different stakeholders of the MDT in finding each could also play a huge role in the success of the NHI concept.