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A worrying number of doctors say they will consider leaving South Africa if NHI is implemented

Union Solidarity’s Research Institute has published the results of a new survey, which sought to find out what healthcare practitioners think about the government’s planned National Health Insurance (NHI) scheme, and what they think will happen if it’s implemented.

According to the report, the overall sentiment among healthcare professionals towards the NHI is generally negative, with many complaining about a lack of information around the whole scheme, and worries that the plans will completely destabilise healthcare in the country.

While some indicated that they were sufficiently knowledgeable about the NHI scheme, a major complaint among respondents was that the whitepapers presented by the health department in June were too vague and lacked any detail about the functioning and implementation of the NHI.

The vast majority said they were sceptical that the scheme will be successfully implemented, saying that more consultation needs to take place.

Healthcare professionals appear to agree that the cost of healthcare in South Africa is not affordable and that everyone has the right to quality healthcare – but are less united in the view that everyone should get the same level of healthcare irrespective of whether they pay for it or not.

Thus, the overall belief is that the subsidy system – the rich subsidising the poor and the healthy subsidising the sick – is not fair.

“Apart from the unaffordability of medical aid funds and private medical care, there is no agreement on the basic cornerstones of the NHI,” Solidarity said.

“This is why (the majority) indicated that there had not been sufficient consultation with interested parties with regard to the objectives and planning of the NHI.)”


Worrying consequences

One of the most worrying findings in the survey was that 83.2% of healthcare workers believed that private health professionals will leave the country if the NHI is implemented. 43% of the respondents said that they themselves would consider emigrating.

There was also a firm belief that the scheme would completely destabilise the country’s healthcare as a result. The major points of concern are:

  • Shortages of specialists, doctors, nursing staff and other healthcare workers;
  • Financial management of the NHI;
  • Purchasing and distribution of medicines and equipment; and
  • Maintenance of infrastructure and equipment.

Solidarity previously highlighted 12 major concerns surrounding the NHI, which has left many questions unanswered, particularly around financing.

Initial projections of R259 billion needed to launch the scheme were revealed to be a ‘best guess’. Solidarity anticipates that R369 billion in extra tax would need to be collected by 2025 to cover the NHI – after which, R156 billion will be needed every year.

This means an additional tax of 5% of GDP will be required, with an automatic tax addition of 1%-2% being considered, or even an automatic deduction by employers of 1.5%-4%, or premium being charged.

The full survey results can be read here.




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