Phaahla Shines Light on National Health Insurance Act

national health insurance act
24 May 2024

The provisions of the National Health Insurance Act will be implemented in phases.

The health minister, Dr Joe Phaahla, highlighted this in a speech at the signing of the act last week.

The minister added that it was always government’s intention to have a “rational, structured and phased approach implementation”.

The minister pointed out that, without the accompanying regulations, directives, and operational procedures, the transformative impact of the act cannot be realised.

He indicated that Section 9 of the act serves as the initial point of action, setting up the National Health Insurance Fund as an autonomous public entity, as outlined in Chapter 6, and listed in Schedule 3A, of the Public Finance Management Act.

“This provision requires the establishment of a Board and other governance structures, which are critical elements for accountability and oversight purposes”, he said.

The Act empowers the minister to appoint a Board, but the “process involves multiple conditions and steps, such as conducting public interviews, public nominations, shortlisting criteria, appointment of the chairperson, and requiring Cabinet approval”.

Regulations as mandated by Section 55 are currently being drawn up.

The minister confirmed that the draft regulations will be published for comment “encouraging transparency and inclusivity in shaping the governance of the NHI Fund and its enabling structures”.

Once regulations are in place, the minister and the department will proceed with setting up the NHI Fund.

The process is likely to “take between 6 to 12 months post-proclamation of the relevant sections of the Act, with subsequent phases involving additional regulations and implementation steps”.

The act, published in Government Gazette 50664, aims to:

  • achieve universal access to quality health care services in the Republic in accordance with section 27 of the Constitution;
  • establish a National Health Insurance Fund and to set out its powers, functions and governance structures;
  • provide a framework for the strategic purchasing of health care services by the Fund on behalf of users;
  • create mechanisms for the equitable, effective and efficient utilisation of the resources of the Fund to meet the health needs of the population;
  • preclude or limit undesirable, unethical and unlawful practices in relation to the Fund and its users; and
  • provide for matters connected herewith.

The Act takes effect on a date still to be determined by the president.

Different provisions of the act may come into effect on different dates.

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(This article is provided for informational purposes only and not for the purpose of providing legal advice. For more information on the topic, please contact the author/s or the relevant provider.)
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