15/05/2024
Letter from Discovery CEO:
“Dear Colleague,
I am writing to you following the announcement that President Cyril Ramaphosa intends to sign the National Health Insurance (NHI) Bill on Wednesday. We share the concerns and disappointment reflected in the statement by The South African Health Professionals Collaboration (SAHPC), given the technical and constitutional flaws in the NHI Bill and in the legislative processes for adopting the Bill.
Discovery’s position on the NHI remains clear: we unequivocally support universal health coverage and believe that a workable NHI is central to achieving this. However, in its current form, the NHI Bill is unconstitutional and unfeasible without private sector collaboration and broader funding sources. We remain strongly of this view and will continue to advocate for an NHI that is viable and to the benefit all South Africans.
To keep you fully informed and to allay any fears that you may have, it is important that I share some specific, critical points on this matter:
No impact on medical schemes for the foreseeable future
Despite the Bill being passed, full implementation remains a long way off – several years at least, likely decades. In the interim, medical schemes and the private healthcare sector will continue to operate as always, without any changes to Discovery Health or the medical schemes administered by Discovery Health. In other words, there will be no impact on medical scheme members or healthcare providers across the health system.
Section 33 of the NHI Bill states that only once the Bill is ‘fully implemented’ will medical schemes be limited to providing ‘complementary cover to services not reimbursable by the NHI’. The timeframes for ‘fully implemented’ are not clear and the benefits that will be provided by NHI are not defined. Without clear timeframes and unless the NHI provides benefits similar to those offered by medical schemes, medical schemes will continue to play a significant role in the healthcare system in the long-term.
Implementation is many years away
The NHI is an inordinately large and complex initiative that proposes unprecedented reforms to the health system, including extensive reorganisation of the public health sector at National and Provincial levels. Considerable planning and preparation is therefore required before it can be implemented.
Critically, the largest barrier to implementation of a workable NHI is funding. There is no funding plan yet and given the country’s constrained fiscal position, low economic growth and narrow tax base, this can only be solved in the longer term. We unfortunately see no scenario in which there is sufficient funding for a workable and comprehensive NHI in its current form – hence our conviction that private sector collaboration is vital.
Furthermore, significant flaws in the Bill and the legislative processes followed in promulgating the Bill, will likely result in the Bill being challenged on numerous fronts, likely leading to further substantial delays.
The way forward
The President’s signing of the NHI Bill will understandably cause additional uncertainty and anxiety across the health sector. However, with many significant matters still to be navigated, I urge you to remain focused on the facts and not be distracted by the noise.
In keeping with Discovery’s Core Purpose to ‘make people healthier and enhance and protect their lives’, as well as our values, we will do the right thing and will not shy away from our responsibilities here. We will continue to stand proudly by our healthcare partners and providers across the health system. South Africa has universally brilliant and committed doctors, nurses, and hospitals and more. It is a unique national asset, and critical in supporting the public healthcare system. We will also ensure that members of Discovery Health administered medical schemes continue to have access to the outstanding healthcare services across the system. Finally, we will continue to invest in both the public and private healthcare systems, for the good of all our country’s people.
I will share further developments following the President’s address tomorrow.
Sincerely,
Ron
Chief Executive Officer
Discovery Health”
