New Warnings on National Health Insurance Proposals

NHI could effect medical schemes In the long term only very rich people could afford medical cover.

Jan Howel, an actuary with OMAC Actuaries and Consultants, warned that the proposed National Health Insurance scheme could have serious long term effects on South Africans' ability to afford healthcare.

According to Howel, if the proposals in their current form are implemented, they will have very little effect on medical schemed in the short to medium term.

However, he warned that in the long term "only the very rich will be likely to afford both the NHI tax and a medical scheme for their families."

He also said that the role of medical schemes would change dramatically.

"Individual medical scheme members will not be permitted to opt out of the NHI," he predicted. "South African citizens will be obligated to contribute to a NHI tax, which will be calculated according to an individual's income."

"As a result," he said, "medical schemes are likely to offer members a greater choice with regards to healthcare providers and more convenient timing of procedures, in the hope of enticing members who might not be satisfied with the choices available on the NHI."

He said that should the introduction of the NHI result in the adjustment of some of the current requirements of the Medical Schemes Act, some would start to offer insurance cover, meaning that they could essentially decline cover for sick people.

"Under these adjustments, schemes may also be allowed to choose which benefits to cover, as there may be no regulation regarding a minimum set of benefits," said Howell.

He urged South African medical schemes and their members to comment on the NHI proposals when they get released in the near future, in order to have their say and get their points across.