The National Health Insurance (NHI) system holds much promise for South Africans. As cash strapped citizens look forward to the possibility of accessing private healthcare services in South Africa, the question that is often raised is “will medical be necessary?”. The reality is that even South African medical aid members are looking for some reprieve as medical aid contributions rise each year while benefits appear to dwindle. But there are many considerations before one gives up the protection of medical aid to depend on the National Health Insurance.

Find cover that suits your budget

Despite all these benefits and advantages of both a South African NHI there are also the cons. The NHI is a very ambitious project by any measure and with over 15 million South Africans already on government welfare of some sort, is there the funds to make the NHI a reality?

Since the NHI will be opened to all South Africans irrespective of their income level, there is also the concern that government will just not be able to fund such a system if people opt for the NHI over medical aid. The figure has been climbing – R100 billion, R200 billion a year. But where will this money come from with the South African taxpayer already being overburdened and the unemployment rate hovering around 25%. Even if the money is available, what about the level of care offered by the NHI? Can it ever match the private healthcare system in South Africa? Or are the private health facilities and service providers expected to open their doors to NHI members? These questions will always linger until the final details of the NHI have been ironed out and made into law.

Medical aid will be around for a long time

The key to accessing private healthcare for now, and even after the NHI launch, is medical aid. While there is an oversupply of medical aid providers in the South African landscape, the reality is that these are properly managed and efficient organisations that provide benefits to the South African system like no other private or state insurance product in the world. Ultimately it boils down to quality and price but for South Africans to receive the best level of healthcare, medical aids seem like the only option for now and at least in the near future.

There is no denying that the medical aid industry in South Africa may need a bit of shake up. It is expensive but otherwise it is a fairly efficient and hugely beneficial financial product when you need it the most. As long as there is demand there will be supply. Therefore the NHI and its potential advantages should be seen as a separate entity from medical aid as long as South Africans can afford it. And if South Africans cannot afford to pay for medical aid, the reality is that the industry will realign itself to be affordable for the taxpaying citizens.

After all, a taxpayer who cannot afford private services for themselves are unlikely to be able to pay for state-subsidised services for themselves and those citizens who are not taxpayers. South African medical aid members should not be thinking of giving up their medical aid anytime soon. Even if the initial NHI rollout proves viable enough for a national rollout, there will always be the disparity between state-subsidised services and private services. This can still be seen in countries with well established National Health Insurance system – private care still offers a different level of service that state care.

There is no doubt that the NHI will be beneficial to South Africans. But this will in no way eradicate the medical aid member base. Look beyond health care – did the Gautrain and Bus Rapid Transport (BRT) system end private car sales or substantially ease traffic congestion on SA roads? South African has a strong democracy and capitalism is the cornerstone of any healthy democracy. As long as this is a democratic country, there will be consumer choice. Medical aid is undoubtedly at the top of the list of sensible consumers in South Africa, both for themselves and their families.

National Health Insurance (NHI) and Private Medical Aid
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