Your taxes will increase to fund NHI, leaked copy of bill shows

Doctors, health workers, hospitals and clinics will need to be accredited to provide care, according to the proposed NHI Bill.
Doctors, health workers, hospitals and clinics will need to be accredited to provide care, according to the proposed NHI Bill.
Image: Brett Eloff

The government's much-vaunted National Health Insurance (NHI) will be paid for, largely, by increased taxes.

This includes taxes paid by employers and workers, as well as an increase in personal income tax.

This is according to a leaked version of the National Health Insurance Bill, set to be officially released on Thursday morning. SowetanLIVE's sister publication TimesLIVE is in possession of the leaked copy.

The NHI Bill is set to be debated in parliament after being approved by cabinet.

The bill explains that a single fund will buy healthcare, medicines, supplies and pay doctors and hospitals for all South Africans. It will be called the National Health Insurance Fund.

Users will have to register to receive the service, which will be free of charge.

Providers - doctors, nurses, specialists, pharmacies, hospitals, private and clinics - will have to register to provide their services. They must be accredited to provide care and pass standards set by the Office of Health Standards Compliance (OHSC). 

The bill says an NHI Fund that buys all the health services in the country will be paid for by an increase in taxes and money from existing taxes. It suggests a payroll tax, paid by employer and employee. It also says there will be an increase in personal income tax.

On top of this, the medical aid tax credits currently given to people on medical schemes - who do not generally use state services - will be stopped and paid into the NHI Fund.

The bill also says provincial funds for healthcare will be moved to a single fund.

It says users will get healthcare in a “reasonable time period” - although this was not specified.

If people want to have a medical aid, they will be allowed to - but it will only be for services not covered by the fund or if one doesn’t qualify for NHI, for example if one is an illegal immigrant. 

Once NHI is fully implemented after 2026, and when the health minister decides so, medical schemes "may only offer complementary cover to services not reimbursed by the fund".

General practitioners will refer patients to specialists. Patients will have to see nurses and GPs first for an assessment and cannot go directly to a specialist for healthcare.

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