The National Health Insurance (NHI) was proposed by the African National Congress (ANC) in 2007 but until now, proposals such as these have not been taken seriously as South Africa has tried to achieve a health system that provides health care accessible to all. The core intention of this reform of the NHI is to raise up to 5% of Gross Domestic Product (GDP) in additional taxes to achieve a total public spend equivalent to 8% of GDP. The ANC have procured 4 documents to date regarding the NHI and some proposals contain important financial and related efficiency implications which are not clear. The NHI has put forth many recommendations which will be discussed further.
Objectives of National Health Insurance:
The NHI plans to provide
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The NHI wants all purchases of the existing public health care system to be done by the NHI. They also want a district team be made to provide population health services. They propose that there should be 1 team of every 10000 people. This means that there will be 5000 teams, 5000 doctors/clinical associates and nurses, and 15000 to 20000 community health workers. These district teams should be supported by health professionals who should provide primary care on a capitation basis. Private pharmacies should be contracted to provide an increased access to medicines.
The NHI wants its benefits to be available to every citizen of the country and all legal residents. These benefits should be provided by accredited public and private providers that are contracted to the NHI Fund. Existing private general practitioners should be accredited in the system if they work in multi-disciplinary practices. The NHI also wants at least 25% of all facilities to be accredited annually so that all facilities will be fully accredited after 5 years.
The NHI wants general taxes to be increased as well as a specific tax system for health purposes that will raise funds amounting to approximately 5% of GDP which will be additional to the 3% already in the public health budget. They also want to offset the fiscal impact of the