Why HR practitioners need to keep their eyes on the NHI debate


If it becomes a reality it will have major implications for employee benefits.

The discussion around the National Health Insurance (NHI) is one that is bound to impact HR professionals in so far as it will affect medical aid contributions and other health-related employee benefits. The Department of Health has indicated that anybody who can afford to contribute to the national fund will be obligated to do so, which implies that, in addition to their medical aid premiums, employees will be required to make contributions to the NHI Fund.

Lauren Salt , who is an associate at Baker Mckenzie, and Rui Lopes, who is an associate in the Dispute Resolution Practice Group at the same law firm believe this could result in employers choosing to cease making private medical aid contributions on behalf of their employees and “a unilateral change to the employees’ terms and conditions or a potential unfair labour practice relating to the withdrawal of benefits.”

In this aritcle, they wrtie: “For those employees who decide to stay on a private medical aid scheme in addition to contributing to the NHI Fund, the draft Medical Schemes Amendment Bill has made several changes to the current system which appear to be advantageous for medical scheme members. It abolishes co-payments, requires medical aid schemes to make full payment of the patient’s expenses, and removes medical aid brokers.

“If these amendments are passed, medical aid scheme members who have raised concerns about above-inflation premium increases and exposure to co-payments should see immediate improvements. However, the changes could also potentially cause medical aid schemes to raise member contributions to cover their increased obligations.”

Last week, the Institute of Race Relations (IRR) provided the office of Minister of Health Dr Zweli Mkhizethe with names of over 45 000 South Africans who are opposed to the government’s proposed policy of National Health Insurance (NHI) and who endorse the IRR’s solution to the South African healthcare crisis.

The IRR has also written open letters to South Africa’s largest medical aid providers to determine what they are doing to protect the interests of their members. The IRR has suggested a number of reforms to the healthcare sector in South Africa. These include improving public healthcare facilities through need merit-based appointments, strict accountability for poor performance, and effective action against corruption and wasteful spending. 

The institute believes the burden on the public system should also be reduced by increasing access to private healthcare. Low-cost medical schemes and primary health insurance policies should be allowed, while poor households should be helped to join these schemes or buy these policies through tax-funded health vouchers. 

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