Evaluating the potential impact of National Health Insurance on medical scheme members' rights to have access to health-care services in South Africa

Abstract

The National Health Insurance Bill proposes to establish a national health insurance scheme that aims to provide universal access to health-care services for everyone. Section 33 of the Bill also proposes to limit the provision of parallel services by medical schemes if such services are provided or covered by the tabled NHI scheme. The establishment of the NHI scheme is likely to have a negative effect on the existing access rights of general private health-care users, particularly members of medical schemes. The NHI scheme may enhance access to and the quality of health-care services for millions; however, enabling large portions of the population to access services currently provided by costly private practitioners - services at present almost exclusive to a minority - is not without its perils. It risks negatively impacting on existing access rights and reducing the quality currently enjoyed by users of private health-care services. The propriety of these potential infringements is not necessarily suspect, and may in fact be justifiable. However, this contribution argues that the limitation proposed under section 33 of the NHI Bill is cause for concern. The contribution explores the state's constitutional duty to observe and respect the right of members of medical schemes to access health-care services. It uncovers the constitutional shortcomings of the limitation, and argues that it does not appear to serve any particular legitimate economic or legal purpose.