A critical reading of the recently approved National Health Insurance (NHI) Bill raises important questions and concerns about its implementation and potential consequences, according to leading law firm APA Africa.

• As of 14 June 2023, the National Assembly has approved the National Health Insurance Bill, which was adopted by the Parliamentary Portfolio Committee.
• The Bill seeks to establish the National Health Insurance Fund, which Fund will be used to purchase healthcare services and products from healthcare service providers and establishments (such as hospitals).
• These services would in turn be accessible to the public sector through the National Health Insurance Scheme.
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While the objective of achieving universal access to quality healthcare is commendable, the hurried nature of the Bill’s formulation and its gaps in addressing key issues pose significant challenges.

One of the primary concerns is the affordability of the National Health Insurance (NHI) Scheme. The Bill fails to provide clear details on how the scheme will be financed and whether it will rely on taxation or mandatory prepayment methods. The potential impact on the general public needs to be thoroughly examined and understood.

// APA Africa Candidate Attorney, Justin Blume

Another critical aspect is whether the public health sector has the capacity to deliver the required services to those who will gain access through the NHI Scheme. The effectiveness of the scheme relies heavily on the ability of healthcare providers to meet the increased demand without compromising the quality of care. The allocation of funds to the National Health Insurance Fund also raises questions.

It is crucial to consider whether these funds could be better utilized to improve the overall quality of the public healthcare industry and the healthcare sector as a whole. A comprehensive assessment of priorities is needed to ensure the best utilization of resources.

The scope of benefits covered by the Fund and the rate of reimbursement are essential factors in assessing the affordability of the NHI Scheme and its impact on quality healthcare provision. Without clear details on these aspects, it is challenging to evaluate the true implications of the scheme.

// APA Africa Candidate Attorney, Justin Blume

Additionally, the relationship between the Fund and private medical schemes requires clarification. How the NHI Scheme will interact with existing private insurance options is an important consideration, particularly for those who can afford private health insurance. The potential impact on private health insurance members needs to be addressed, as the NHI Scheme appears to be a comprehensive plan that excludes reliance on private medical schemes.

The Bill’s preamble highlights its goal of creating a single framework for public funding and purchasing of healthcare services. However, the responsibility to address the aforementioned questions is largely delegated to the Minister of Health, who will need to make critical determinations based on clinical and medical expertise. Placing such a burden on a single individual could have serious consequences for the healthcare sector if competent and substantive determinations are not made.

While the objective of universal access to quality healthcare is commendable, the gaps in the Bill’s formulation and the lack of substantive answers to critical questions raise concerns.

It is imperative that the Minister of Health provides clear and comprehensive regulations to address these gaps and ensure the long-term viability and success of the NHI Scheme. Without careful consideration and robust planning, the healthcare sector may face significant challenges and potential negative consequences.

// APA Africa Candidate Attorney, Justin Blume

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