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Tuesday | 31 July | 2018 A doctor’s perspective: NHI heading for a national health disaster

The goals behind national health insurance may be very noble, and no one wants to deprive any citizen of quality health care, but this bill has many detrimental consequences which will destroy South Africa’s health care. This is according to the opinion of Dr Ronel Goosen.* Dr Goosen, who has been practising as a general practitioner for 26 years and who is currently working at a hospital in Rustenburg, recently expressed her concerns about the possible implementation of National Health Insurance (NHI) in an exclusive interview with Solidarity. She described the NHI as a national health care disaster waiting to
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Tuesday | 31 July | 2018 Burnout and stress within the NHI

The first thought that comes to mind when thinking of the NHI of the future is overcrowded waiting rooms at doctor’s consulting rooms, clinics and hospitals, and having to wait for hours to see a doctor or to be helped. However, what does this picture look like from the viewpoint of the health care worker? What will their experience be like from within the NHI? Results of a study done in the USA (read more on the study here: has now revealed that doctors experience dramatically fewer symptoms of burnout and stress when they practice in smaller practices where
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Friday | 29 June | 2018 What is the NHI?

The NHI will be a state-run national health fund to provide essential healthcare and general cover for all South Africans on an equal footing. The state will compile a basket of services, and everything in this basket will be dealt with by the state only. The state will deal with the total administration of the fund. In this regard the state is making no secret that rationing will indeed be applied in the event of shortages. The NHI will buy and provide “all” health services on behalf of consumers / patients. The package to be provided is based on basic
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Friday | 29 June | 2018 Why the NHI?

Minister Motsoaledi explained that there was considerable inequality in access to healthcare in South Africa that had to be put right. More than half of the doctors in South Africa serve only 16% of the country’s population – those who belong to medical aid funds or who can afford to pay for medical services themselves. As far as medical specialists in South Africa are concerned, 80% are working in the private sector and only 20% in the public sector to serve 84% of the population. He sharply criticised the highly expensive private hospitals and private medical practitioners: “overservicing of the
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Friday | 29 June | 2018 Concerns

Financial management of the NHI The NHI, as envisaged at present, will be the largest state institution in the history of South Africa. Given the omnipresent mismanagement in state institutions, this is an immense source of concern. How is purchasing and managing of assets, medication and equipment going to work? How and by whom is it going to be distributed? The fact that the state will be the sole purchaser means that any errors in this regard could have drastic consequences. A central fund has to be managed perfectly to be effective. When the risk is spread among a multitude
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Friday | 29 June | 2018 Implications

For you The NHI will be compulsory for all citizens and legal long-term residents. You will not have an option to join or not to join. It is not clear how all the immigrants will be dealt with. When you need medical services, you will have to visit a facility that has been approved by government. At the approved facilities you will receive only the tests, treatments and medicine that have made available, approved, purchased and provided by the state. You will not be required to pay any levies or excesses. Current tax benefits (tax credits or refunds) based on
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