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The National Education, Health and Allied Workers’ Union [NEHAWU] as a formation that has pioneered and spearheaded the campaign on the introduction of the National Health Insurance [NHI], welcomes the announcement on the National Health Insurance [NHI] Bill by the Minister of Health, Dr Aaron Motsoaledi this afternoon. This is in line with the commitments made by the ANC in terms of the 2014 election manifesto and it takes forward the resolution taken by the ANC’s 54th Conference held at NASREC, Gauteng.

However, we also note that the Minister simultaneously released the Medical Scheme Amendment Bill. We are concerned that the Minister decided to release the Medical Scheme Amendment Bill before the publication of the findings of the Health Market Inquiry headed by Justice Sandile Ngcobo on the 28th June 2018, as this inquiry was meant to deal with matters that have a direct bearing and correspondence to the current operations of the medical aid schemes and the private hospital providers.

More importantly from our point of view as NEHAWU, expect that the Health Market Inquiry to raise concerns and make recommendations regarding the current oligopoly of the three private hospital groups or monopolies that has been entrenched since the late 1990s – which saw the private health costs exponentially escalating since. Therefore, we would have expected the Minister to introduce a more comprehensive regulatory intervention that also deal with this oligopoly and their price-gauging as monopolies.

It is common cause that there has been a serious regulatory failure on the part of the government when it comes to medical aid schemes and private hospital monopolies for too long. And this has been exacerbated by the ruling of the Competition Tribunal in 2004. Prior to 2004, the private healthcare sector practised collective bargaining between medical aid schemes and private health providers in jointly publishing and determining charges or tariffs, which was itself not an adequate mechanism short of government regulation.

This challenge of price/tariff regulation has therefore been negatively affected by the minimal role that is played by the state in price determination at the moment. As NEHAWU we have previously called on the Department of Health to re-introduce the National Health Reference Price List (NHRPL) as the court ruling abandoning the published 2010 NHRPL did not in any way prevent the department from following the correct procedure to re-establish the NHRPL.

Therefore, even though we recognise that the White Paper on the NHI anticipated that there would have to be some amendments to the medical aid scheme legislation, and that this “will be initiated in the second phase of the implementation as part of the broader phased implementation approach” of the NHI, we believe that some of the necessary regulatory intervention are long overdue. We therefore hope that the issues arising from Medical Scheme Amendment Bill would not detract from the NHI Bill and undermine its processing in Parliament.

We take it on trust that the Medical Scheme Amendment Bill is introducing amendments as part of the transitional process and to align it with the phased implementation of the NHI and that it its amendments are not in themselves an end-state.  As NEHAWU we shall study the bills and prepare for our participation in the public hearings through which we shall provide our comprehensive response and posture towards these legislations.
 
Issued by NEHAWU