The role of the Minister of Health in the National Health Insurance Bill: Challenges and options for the Portfolio Committee on Health

Solanki, Geetesh; Cornell, Jennifer; Wild, S; Morar, R L; Brijlal, V

doi:10.7196/samj.2022.v112i5.16414

Cited by 3 publications

(6 citation statements)

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“…The National Assembly approved the National Health Insurance (NHI) Bill [1] on 12 June 2023. [2] The Bill was passed with only relatively minor amendments in response to the concerns raised [3] via the Portfolio Committee on Health's public participation process. This has resulted in a very mixed response, with extensive coverage in media and online platforms.…”

Section: In Practicementioning

confidence: 99%

South African healthcare reforms towards universal healthcare – where to next?

Solanki,

Wilkinson,

Myburgh

et al. 2024

S Afr Med J

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The National Assembly approval of the National Health Insurance (NHI) Bill represents an important milestone, but there are many uncertainties concerning its implementation and timeline. The challenges faced by the South African healthcare system are huge, and we cannot afford to wait for NHI to address them all. It is critical that the process of strengthening the health system to advance universal healthcare (UHC) begins now, and there are several viable initiatives that can be implemented without delay. This article examines potential scenarios after the Bill is passed and ways in which UHC could be advanced. It begins with an overview of the trajectory of health system reform since 1994, then examines the scenarios that may emerge once the Bill is passed by Parliament and makes a case for finding ways in which UHC could be advanced within the country, regardless of any legal or financial barriers that may delay or limit NHI implementation.

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Section: In Practicementioning

confidence: 99%

South African healthcare reforms towards universal healthcare – where to next?

Solanki,

Wilkinson,

Myburgh

et al. 2024

S Afr Med J

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“…Concerns about governance, specifically related to the role and powers of the MoH, featured prominently at the hearings and were examined in detail in an earlier SAMJ publication. [4] The key issues are summarised here.…”

Section: Governancementioning

confidence: 99%

“…The meeting summaries and the presentations and submissions of 117 respondents available on the PMG website were captured into a database and analysed. The database was structured to capture information on the data capture process (data capturer, checker and reviewer), respondent information (organisation, date presented), and inputs provided by theme (support for National Health Insurance (NHI), concerns around corruption, governance and the Minister of Health (MoH), constitutional infringements, funding, access and benefits).To make the analysis publicly available as soon as possible, an editorial [3] and an 'In Practice' article [4] were published in the South African Medical Journal (SAMJ) and a series of op-eds, each covering a key theme, were published in partnership with the Daily Maverick. [5][6][7][8][9][10][11][12] These earlier articles cover the inputs in detail, while this article provides an overview of the entire series.…”

mentioning

confidence: 99%

“…To make the analysis publicly available as soon as possible, an editorial [3] and an 'In Practice' article [4] were published in the South African Medical Journal (SAMJ) and a series of op-eds, each covering a key theme, were published in partnership with the Daily Maverick. [5][6][7][8][9][10][11][12] These earlier articles cover the inputs in detail, while this article provides an overview of the entire series.…”

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confidence: 99%

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Healthcare Delivery

Solanki

Myburgh²,

Wild³

et al. 2022

S Afr Med J

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The Portfolio Committee on Health (PCH) obtained public input on the National Health Insurance Bill (the Bill) from a wide array of individuals and organisations between May and September 2021. The record of these submissions collated by the Parliamentary Monitoring Group provided the source material for this article. The concerns, suggestions and other issues raised by respondents were analysed to determine what challenges and options the PCH needs to take seriously as they prepare the Bill for Parliament. Prominent issues raised included concerns about the proposed governance structure, flaws in the funding model, the risk of corruption, the constitutional and human rights at risk, limited access to care for several groups, and the unresolved nature of the medical benefits to be provided under the Bill. Future legal contestation of the Bill on several of these issues has the potential to stop or delay its implementation for a long time. The PCH has some hard decisions to make: whether to address these concerns with quite radical revisions of the bill, to omit problematic elements, or to leave it unchanged, and accept the contestation this will bring.

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“…See, for example, IRR 2018[199], Section27 et al 2018[194], Dullah Omar Institute 2019[200], SAMA 2019[184], Medical Brief 2022[202], Solanki et al 2022[203].…”

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confidence: 99%

A socio-political history of South Africa’s National Health Insurance

Whyle,

Olivier

2023

Preprint

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Background. Spurred by the WHO’s endorsement of universal health coverage as a universal goal of health systems, many countries are undertaking health financing reforms. The nature of these reforms, and the policy processes by which they are achieved, will depend on context-specific factors, including the history of reform efforts and the political imperatives driving reforms. South Africa’s pursuit of universal health coverage through a National Health Insurance is the latest in a nearly 100-year history of health system reform efforts shaped by social and political realities. Methods. We conducted an interdisciplinary, retrospective literature review to explore how these reform efforts have unfolded, and been shaped by the contextual realities of the moment. We began the review by identifying peer-reviewed literature on health system reform in South Africa, and iteratively expanded the search through author tracking, citation tracking and purposeful searches for material on particular events or processes referenced in the initial body of evidence. Data was extracted and organised chronologically into nine periods. Results. The analysis suggests that in South Africa politics; the power of the private sector; competing policy priorities and budgetary constraints; and ideas, values and ideologies have been particularly important in constraining, and sometimes spurring, health system reform efforts. Political transitions and pressures, including the introduction of apartheid in 1948, anti-apartheid opposition, the transition to democracy, and corruption and governance failures, have alternately created political imperatives for reform, and constrained reform efforts. In addition, the country’s political history has given rise to dominant ideas, values and ideologies that imbue health system reform with a particular social meaning. While these ideas and values increase opposition and complicate reform efforts, they also help to expose the inequities of the current system as problematic and re-emphasise the need for reform. Conclusion. Ultimately, this analysis demonstrates the context-specific nature of health system reform processes and the influence of history on what sorts of reforms are politically feasible and socially acceptable, even in the context of a global push for universal health coverage.

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The role of the Minister of Health in the National Health Insurance Bill: Challenges and options for the Portfolio Committee on Health

Cited by 3 publications

References 0 publications

South African healthcare reforms towards universal healthcare – where to next?

South African healthcare reforms towards universal healthcare – where to next?

Healthcare Delivery

A socio-political history of South Africa’s National Health Insurance

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