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JEREMY MAGGS: Now, it seems we might be getting closer to the signature of the NHI (National Health Insurance) Bill and at the flourish of a pen healthcare in South Africa would change forever. There is growing concern though, in the medical benefit space that certainly is increasing. I want to give you another view on this. Gary Feldman is with us now, executive head of Healthcare Consulting at NMG Benefits. Gary, welcome to you. What’s your sense, do you think the president (Cyril Ramaphosa) is going to sign this bill anytime soon?
GARY FELDMAN: Good afternoon, Jeremy, and good afternoon to the listeners. Jeremy, ja, I think at this late stage, the president doesn’t have a choice. I don’t think he can send it back to the parliamentary committee, I think he’ll have egg on his face. But I don’t think the listeners should be too concerned about that. If he does sign it, once he’s found his pen, I think there’s still a lot of water to flow into the sea before we actually see a change in the healthcare environment in South Africa.
Read: Kick the NHI Bill back, it’s unconstitutional – Busa to Ramaphosa
JEREMY MAGGS: So let’s talk about that water if we can. Are you suggesting that it’s not immediately going to impact the business models or the strategy of existing medical benefits companies?
GARY FELDMAN: Absolutely, Jeremy. If you look at once it’s been signed, there is still a lot of different legislation that needs to be adjusted as well, amongst others, the Medical Schemes Act needs to be changed and that only goes once the NHI Bill has been proclaimed. So that has to be changed and then in the interim…
We do believe that there are a number of societies, organisations like medical schemes, like Business for South Africa (B4SA), that will go to the Constitutional Court, challenging the constitutionality of the NHI Bill.
I think we are all in favour of universal healthcare. That’s absolutely non-negotiable. We do believe every South African citizen and permanent resident should have access to universal healthcare. But you don’t need the NHI to get universal healthcare. Universal healthcare really means that more people have access to treatment at an acceptable rate or free for the low-income earners or unemployed. But you don’t need NHI to achieve that, and I think this is what people don’t understand.
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JEREMY MAGGS: Gary, what steps should medical benefits companies be taking right now to prepare them for what you are suggesting is an inevitable integration into the system?
GARY FELDMAN: Well, Jeremy, as the NHI Bill states at the moment, which is fairly vague, it says that any private medical scheme will not be able to offer the same benefits as NHI offers. So a medical scheme will only be able to offer top-up benefits. But, as I said, I don’t believe that that will happen for at least another seven to 10 years because the medical schemes bill clearly states as well that the medical scheme will not be able to offer that on full implementation.
Now we don’t even know what full implementation means because there is so much to clarify and to basically put in place before the NHI Bill will be implemented in full.
So that’s why once again, I think people should make sure that they don’t cancel their medical scheme at the moment. I do believe that corporate South Africa should try and get more of their staff covered to alleviate the pressure off the failing public healthcare system at the moment. So at least employed people do have access to some form of private healthcare in South Africa.
JEREMY MAGGS: Down the line though, of course, everybody is concerned about added cost.
GARY FELDMAN: Well, I think we might see as soon as the budget next week that the Minister of Finance (Enoch Godongwana) will remove the tax credits, which will be a huge impact on the middle-income sector of South Africa, again because that basically does assist in making private healthcare affordable. I think that will be a bad move from the government’s perspective because as I said, they’re not ready to roll out the NHI Bill. Let people retain their private healthcare cover for as long as possible.
So that’s one thing that we anticipate could happen, as I said, as soon as next week. But there is a host of different elements that the government will have to address and basically ensure that they’re put in place before any change can take place to the private healthcare that a number of South Africans have at the moment.
Jeremy, if you just think about it, there are about 1.5 million people in South Africa who are not on a medical scheme; but do still make use of private healthcare. Those people are like doctors, dentists, who basically make use. They prefer to self-fund their private healthcare. They’re not on a medical scheme. Now, those people will not be able to make use of private healthcare should the NHI Bill be implemented in the way that it’s tabled at the moment because it says clearly that you will not be able to use any form of private healthcare for the services provided by the NHI Bill.
That’s going to create another huge debate from those people as well. It’s not only the private healthcare members who are going to be compromised, but it’s people who have the funding to afford private healthcare at the moment, which will not be accessible.
JEREMY MAGGS: All right. Gary Feldman, I’m going to leave it there. Thank you very much indeed. Obviously, the ball is in the minister’s court and let’s see what emerges come budget time at the end of February.
