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National Health Insurance (NHI)

The People’s NHI Campaign

What is the National Health Insurance (NHI)?

NHI Submissions by PHM-SA

NHI Briefing Papers by PHM-SA

NHI Information Materials by PHM-SA

NHI Articles and Press Releases by PHM-SA

NHI Legislation and Policy

NHI Academic and Research Publications

NHI Lectures, Speeches and Presentations

NHI Media Articles, Media Briefings and Press Releases

 

The People’s NHI Campaign

The People’s NHI Campaign advocates for a National Health Insurance (NHI) that provides everyone with good, equitable healthcare and that builds social solidarity, rather than serving only the health of the few. The campaign opposes the capture of the NHI for corporate profit by groups and individuals with vested interests. For more information about the National Health Insurance, please see the NHI information brochure and the articles below.

To join the People’s NHI Campaign, please do one of the following:

What is the National Health Insurance (NHI)?

The National Health Insurance (NHI) is the key health policy of the South African government. It is aimed at realising everyone’s right to health care as set out in Chapter 2 of the Constitution (the Bill of Rights).

A Government Gazette set out the basic principles of the NHI in 2009:

  • it is a Constitutional right that the public has access to affordable and acceptable quality health services;
  • it is the responsibility of the State to ensure the progressive realisation of the right to health for all South Africans premised on Universal Health Cover; and
  • health services must be funded in an equitable manner that promotes social solidarity.

It proposed to establish an “integrated, prepayment-based health financing system that effectively promotes the progressive realisation of the right to health care for all’’.

Since then, the Department of Health (DoH) has put out a Green Paper and two White Papers, proposing a National Health Insurance Fund (NHIF) to pay for everyone’s health services. This is known as a single-payer system. In such a system, people who access needed health care don’t have to pay the service providers directly. Instead, the NHIF pays public and private providers to deliver the service.

The money for the NHIF comes mainly from progressive taxation. The rich and healthy (who need the least health care while they are young) make the biggest contribution. In this way, they cross-subsidise health care for the poor. This is the key pillar of social solidarity – one of the foundations of the NHI policy. It is based on the principle that health is a public good and a fundamental human right.

There is good evidence to show that tax-based, single-payer systems and strong government leadership are essential for the implementation of Universal Health Cover.

Progressive civil society organisations and public health experts, including the People’s Health Movement South Africa (PHM-SA) and the Treatment Action Campaign (TAC) responded to the Green and White Papers and expressed support for these government proposals.

However, powerful private sector corporate groupings oppose the principle of health as a fundamental human right. They believe that health care is a profitable commodity to be delivered by markets and they are strongly opposed to the single-payer system.

Unfortunately, the DoH seems to have bowed to these corporate interests. It has set up seven implementation structures with strong representation from corporate interests. One of these structures is tasked with advising on the establishment of five separate finance mechanisms in the NHI.

This amounts to effective corporate capture on our NHI. If we allow this to happen, it will perpetuate inequity in health care for generations to come. Poor people, who need most health care will have the least access, while the rich, who on average need less health care, will get the most. The historic opportunity to promote social solidarity and heal the nation will be lost.

In this context, PHM-SA is campaigning for a “People’s NHI” — an NHI that puts people before profits. Our main partners in this campaign are the Treatment Action Campaign (TAC), SECTION27, Rural Health Advocacy Project (RHAP) and Lawyers for Human Rights (LHR).

Through this campaign, we hope to bring together other civil society groupings and movements to establish a broad social movement for people’s health. For more information, please see the articles below.

If you would like to become involved in the campaign for a People’s NHI, please contact Anneleen de Keukelaere at anneleen@phm-sa.org.

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NHI Resources

NHI Submissions by PHM-SA

Green Paper Submission

People’s Health Movement South Africa (PHM-SA). (2011). Submission on the Green Paper on National Health Insurance. Submitted by PHM-SA to the Department of Health, December 2011. Endorsed by SECTION27, Treatment Action Campaign (TAC), Black Sash, Rural Health Advocacy Project (RHAP), Rural Rehab, Rural Doctors Association of South Africa (RuDASA), PASSOP, EarthLife Africa, Africa Health Placements (AHP) and Soul City.

White Paper Submissions

People’s Health Movement South Africa (PHM-SA). (2016). Comment on the National Health Insurance White Paper. Submission by PHM-SA, 31 May 2016.

People’s Health Movement South Africa (PHM-SA). (Coordinator). (2016). Young People’s Recommendations on South Africa’s NHI White Paper. Coordinated and facilitated by PHM-SA, Version 2, 29 July 2016.

NHI Implementation Structures Submission

Treatment Action Campaign (TAC), People’s Health Movement South Africa (PHM-SA), SECTION27, Rural Health Advocacy Project (RHAP) & Stop Stockouts (SSP). (2017). Submission to the National Department of Health on NHI Implementation Structures. 27 November 2017. Endorsed by Lawyers for Human Rights, Doctors Without Borders, Right2Know, Equal Education, RuReSA, RuDASA, Black Sash, CANSA, GroundWork, HEALA, TEKANO, OTASA and Triangle Project.

NHI Bill Submission

People’s Health Movement South Africa (PHM-SA). (2018). People’s Health Movement Submission on National Health Insurance Bill. Submission by PHM-SA, 21 September 2018. Also available here.

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NHI Briefing Papers by PHM-SA

London, Leslie & Sanders, David. (2018). Briefing Paper: A People’s NHI in South Africa – Possibilities, Prospects and Pitfalls, August 2018.

NHI Information Materials by PHM-SA

Reynolds, Louis. (2018). National Health Insurance (NHI) Information Brochure. People’s Health Movement South Africa (PHM-SA), June 2018.

NHI Articles and Press Releases by PHM-SA

London, Leslie. (2018). Can the NHI achieve Health for All? The Pulse, September 2018 Edition. Newsletter of the Public Health Association of South Africa (PHASA).

London, Leslie. (2018). Critique of Five Funding Streams for NHI in Minister of Health’s Presentation at PHASA Conference. 19 September 2018.

People’s Health Movement South Africa (PHM-SA). (2018). PHM-SA demands health equity for all now! Press release, 7 June 2018.

People’s Health Movement South Africa (PHM-SA). (2018). Let’s unite behind a universal health service that caters to all equallyCape Times, 25 June 2018.

People’s Health Movement South Africa (PHM-SA). (2018). Concern over NHI capacity. Cape Times, 25 June 2018.

Reynolds, Louis. (2017). Op-Ed: Has the National Health Insurance process been captured? Daily Maverick, 28 August 2017.

Sanders, David & Reynolds, Louis (PHM-SA). (2018). NHI Bill: Welcome but flawedSpotlight, 5 July 2018. Also available here.

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NHI Legislation and Policy

Motsoaledi, Aaron. (2018). National Health Insurance (NHI). Minister of Health’s presentation at the Public Health Association of South Africa (PHASA) Conference, 12 September 2018.

National Department of Health. (2009). Establishment of the National Health Insurance Advisory Committee. Government Notice No. 903 of 2009. Government Gazette, 11 September 2009, Vol.531, No.32564.

National Department of Health. (2011). Policy on National Health Insurance. (Green Paper). Government Notice No. 657 of 2011. Government Gazette, 12 August 2011, Vol.554, No.34523.

National Department of Health. (2015). White Paper on National Health Insurance Policy. Government Notice No.1230 of 2015. Government Gazette, 11 December 2015, Vol.606, No.39506.

National Department of Health. (2017). National Health Insurance Policy: Towards Universal Health Coverage. Government Notice No. 627 of 2017. Government Gazette, 30 June 2017, Vol.624, No.40955.

National Department of Health. (2017). NHI Implementation: Institutions, bodies and commissions that must be established. Government Notice No. 660 of 2017. Government Gazette, 7 July 2017, Vol.625, No.40969.

National Department of Health. (2018). National Health Insurance Bill, 2018. Government Notice No. 635 of 2018. Government Gazette, 21 June 2018, Vol.636, No.41725.

National Department of Health. (2018). Medical Schemes Amendment Bill, 2018. Government Notice No. 636 of 2018. Government Gazette, 21 June 2018, Vol.636, No.41726.

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NHI Academic and Research Publications

Douwes, Renate; Stuttaford, Maria & London, Leslie. (2018, in press). Social Solidarity, Human Rights, and Collective Action: Considerations in the Implementation of the National Health Insurance in South AfricaHealth and Human Rights Journal, 1 October 2018.

NHI Lectures, Speeches and Presentations

McIntyre, Di. (2017). A universal health system for South Africa: A few final words on NHI. PowerPoint presentation of valedictory address, School of Public Health & Family Medicine, University of Cape Town, 9 November 2018.

McIntyre, Di. (2017). A universal health system for South Africa: A few final words on NHI. Video of valedictory address, School of Public Health & Family Medicine, University of Cape Town, 9 November 2018.

Motsoaledi, Aaron. (2018). National Health Insurance (NHI). Minister of Health’s PowerPoint presentation at the Public Health Association of South Africa (PHASA) Conference, 12 September 2018.

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NHI Media Articles, Media Briefings and Press Releases

NHI and Health for All

London, Leslie. (2018). Can the NHI achieve Health for All? The Pulse, September 2018 Edition. Newsletter of the Public Health Association of South Africa (PHASA).

People’s Health Movement South Africa (PHM-SA). (2018). PHM-SA demands health equity for all now! Press release, 7 June 2018.

Reynolds, Louis. (2017). Op-Ed: Has the National Health Insurance process been captured? Daily Maverick, 28 August 2017.

NHI Bill

Cullinan, Kerry. (2018). NHI: It’s not just about the moneyHealth-e News, 2 July 2018.

Health minister Aaron Motsoaledi briefs the media. Minister of Health’s briefing on the NHI Bill streamed live on SABC Digital News, 21 June 2018.

Kahn, Tamar. (2018). NHI Bill gazetted, paving way for NHI fund, in which the rich subsidise the poorBusiness Day, 21 June 2018.

People’s Health Movement South Africa (PHM-SA). (2018). Let’s unite behind a universal health service that caters to all equallyCape Times, 25 June 2018.

People’s Health Movement South Africa (PHM-SA). (2018). Concern over NHI capacity. Cape Times, 25 June 2018.

Rensburg, Russell (RHAP). (2018). NHI Bill – so near yet so far. Spotlight, 29 June 2018.

Rispel, Laetitia. (2018). South Africa’s universal health care plan falls short of fixing an ailing system. The Conversation, 28 June 2018.

Sanders, David & Reynolds, Louis (PHM-SA). (2018). NHI Bill: Welcome but flawedSpotlight, 5 July 2018. Also available here.

South African Medical Association (SAMA). (2018). Some good, some bad: many questions remain in NHI legislation. Press release, 26 June 2018.

Stevenson, Sasha (SECTION27). (2018). NHI: This Bill is not the path to Universal Health CoverageSpotlight, 26 June 2018.

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Medical Schemes

Cullinan, Kerry & Green, Amy. (2018). Massive changes proposed to private medical schemesDaily Maverick, 26 June 2018.

Green, Amy. (2018). New medical schemes Bill intended to “protect” beneficiariesHealth-e News, 22 June 2018.

Green, Amy. (2018). Findings of private health inquiry to be dumped? Daily Maverick, 10 September 2018.

Gifford, Gill. (2018). SA’s private healthcare ‘not competitive’, Competition Commission findsHealth-e News, 5 July 2018. (Also published as: Medical aid members getting a raw deal, Competition Commission finds after lengthy probeHealth24, 5 July 2018).

Health for All – Globally

Horton, R., Gerada, C., Clarke, R. & Kerslake, B. (2018). What does the NHS need to survive for another 70 yearsThe Guardian, 5 July 2018.

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PHM-SA Demands Health Equity for All Now!

Press Statement For Immediate Release Thursday, 7 June 2018 The People’s Health Movement South Africa (PHM-SA) calls on civil society, communities and allies in health struggles to join in mass mobilisation and community action to realise health equity and the ...

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Towards a People’s National Health Insurance!

On 5 March 2018, the People’s Health Movement South Africa (PHM-SA), Treatment Action Campaign (TAC), SECTION27 and Rural Health Advocacy Project (RHAP) met for a workshop to learn more about National Health Insurance (NHI) financing and to set up a ...

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NHI Pie in The Sky

The following article was written by  Megan Harker Elliott after the event “Student Discussion on NHI” and it was published by the Africa Health News National Health Insurance (NHI) seems pleasant to consider, but far away from realisation- “pie in the ...

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Comment on the reappointment of Dr Aaron Motsoaledi

People’s Health Movement South Africa (PHMSA) welcomes the reappointment of Dr Aaron Motsoaledi as South Africa’s Minister of Health. We applaud his commitment to the health of the nation and to the principles of Primary Health Care. We realise that ...

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