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National Health Act, 2003 (Act No. 61 of 2003)


National Health Insurance Policy towards Universal Health Coverage

Chapter 10 : Conclusion


340. This White Paper is aimed at achieving the goal of universal coverage in South Africa through the implementation of NHI. Implementation of NHI is consistent with the Constitutional commitment to the progressive realisation of the right of access to health services which will lead to a healthy and productive nation in the future to the benefit of all the country’s inhabitants. Most importantly, the universal health system is a reflection of the kind of society we wish to live in; one based on the values of justice, fairness and social solidarity. It is consistent with the global vision that health care should be seen as a social investment and not be subject to trading as a normal commodity. The National Development Plan that also envisages universal health coverage as critical to realising the vision of a long and healthy life for South Africans.


341. National Health Insurance seeks to transform the national health system financing mechanisms. The focus of the transformation is to create a single, publicly owned and administered NHI Fund that strategically purchases personal healthcare services on behalf of the entire population from suitably accredited providers.


342. Moving towards UHC requires transformation of health service delivery and management, particularly to improve the quality in the health sector. Primary Health Care will form the heartbeat of NHI.


343. Transforming the health care financing system requires changing how revenue is collected and, even more importantly, addressing how generated funds are pooled and how quality services are purchased; this is critical for improving the use of available financial resources and the health of the population. Services will be provided free at point use meaning that hardships arising from paying for using health care will be avoided.


344. Equally importantly, making progress towards universal health coverage requires transformation in the governance of the health system and reconfiguration of institutions for pooling of funds and purchasing of services to achieve income and risk cross-subsidisation whilst improving the efficiency in purchasing of personal health services. NHI requires the establishment of strong governance mechanisms and improved accountability to the public for the use of allocated funds.


345. The success of NHI will requires building a responsive health care system that is people-centred. Community involvement will be essential at all levels of the transformed systems to ensure that there is participatory governance, and accountability.


346. Implementation of NHI will require amendment of related legislation and enactment of new laws to ensure that there is not only legislative alignment but also policy consistence across government departments and spheres of government. The policy will also be subject to reviews as implementation happens to ensure that problems are addressed on time and appropriately.