In an effort to address high healthcare costs, ensure the smooth running of the healthcare system
and create equality, government has released the Medical Schemes Amendment Bill and the National Health Insurance Bill.
Druing a recent media briefi ng, Health Minister Dr Aaron Motsoaledi explained that the Medical Schemes Amendment Bill seeks to amend the Medical Schemes Act, 1998
(Act No. 131 of 1998) to align with the National Health Insurance White Paper and the National Health Insurance Bill.
“The fi rst reason for this amendment is that the implementation of the National HeaIth Insurance (NHI)
is not going to be a once-off event but will take place in a phased-in approach.
While this is happening, the population of medical schemes’ beneficiaries need immediate relief
Access to healthcare In addition, the amendment is intended
to align the medical scheme environment to
that which will exist under the NHI so that there is a smooth, harmonious transition that does not disrupt access to healthcare.
“As it is now generally accepted, the cost of private healthcare is out of the
reach of many citizens, even the well-to-do ones,” the Minister noted.
The first amendment is to abolish what has come to be known as co-payments.
Co-payments are when the scheme pays a portion of the bill that a provider (hospital or private doctor) charges a patient.
The load of complaints received from the public by us, the Department of Health, as well as by the Council for Medical Schemes – the medical schemes regulator – justifies this amendment,” he noted.
The Minister added that data showed that medical schemes were holding
“Granted, there is a statutory requirement that medical schemes should have 25 percent of their income in reserve. This is to cater for emergencies.
But presently the R60 billion is equivalent to 33 percent reserves, which means unnecessary accumulation at the expense of patients.”
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