South Africa's National Health Insurance Plan

South Africa's Health Minister Nkosasana Zuma has set up a committee of enquiry to investigate the viability of a national health insurance scheme, in order to bring about "substantial health care reform in the shortest possible time." The NHIS will fund and organize primary health care for all South Africans, and is expected to be set up next year.

The committee's brief, to prepare a detailed, costed plan for the introduction of a NHIS "or a publicly supported alternative," is open-ended but guided as a policy framework, she said. The objectives are universal, non-discriminatory access to quality health care, affordability and sustainability, efficiency and cost control, and consistency with the government Reconstruction and Development Plan. The committee should address inter alia the system's overall feasibility, levels and sources of funding, availability and distribution of the required service providers, facilities and suppliers, and mechanisms and levels of payment to providers of services and products.

Including in the brief options put forward by a previous finance committee is a significant move for Dr Zuma. Earlier this month, Fezile Makiwane, health care financing consultant to the Department of Health, confirmed that she had appointed a special technical committee to study the implementation of an NHIS model named after John Deeble, the Australian health economist who designed it. This model provides for universal cover for primary care, including drugs, and would pay private doctors and other providers on a capitation basis as opposed to fee-for-service. Medical schemes would cover hospital and specialist services. The scheme was to have been financed by a levy on the salaries and wages of employees.