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Send  Share  RSS  Twitter  09 Nov 2011

HEALTH CARE: Lessons To Be Learnt From Africa


Recent Western Cape Business News

Government’s proposed National Healthcare Insurance (NHI) scheme must be embraced, not just because all citizens have the right to quality healthcare, but because without implementing such a measure, South Africa will be left behind other major emerging African economies that have already begun introducing similar schemes.


According to Olabode Olajumoke, Employee Benefits Actuary at Aon Hewitt South Africa, many people mistakenly believe that South Africa will be the first country in Africa to consider offering some form of universal healthcare. “This is actually not the case, as countries such as Nigeria and Kenya have already introduced some form of medical benefit to their citizens. Both these schemes are still in the early stages and while each faces its own set of challenges, it is however positive that these regions are making strides forward to address the healthcare issue.


Given South Africa’s larger economy and more resources at its disposal, not only are we perhaps better equipped to meet the healthcare needs of the country, we are also in a position to learn from the successes, and mistakes, already made by other countries.”


Olajumoke says that in Nigeria the government has introduced some form of NHI for basic income groups, which is expected to later be rolled out to students and then gradually other demographics. In Kenya, the government has also started rolling out a scheme to cater for the healthcare needs of the lower income bracket. “Both of these schemes are income means tested, which seems to be the most practical and fairest way to fund such a model.


The Nigerian National Health Insurance Scheme (NHIS) has a core aim of providing universal, easily accessible and affordable healthcare for all Nigerians through various cost sharing methods. As with many countries, Nigeria is facing increasing healthcare costs, coupled with the generally poor state of the national health system, a shortage of medical resources and/or medical professionals. The NHIS, which currently covers about 2% of the population, was seen as an avenue to checkmate these shortcomings and several managed care organisations have now adopted the NHIS philosophy by offering basic products in addition to their selection of benefit offerings to their clients.


In Kenya, there is a choice between public health insurance or private. Public health insurance in Kenya is provided by the National Hospital Insurance Fund (NHIF), while private care is provided via individual medical insurance companies. The NHIF currently covers about 15% of the population and is open to all employed and unemployed Kenyans and their declared dependants (spouse and children) and coverage includes in-patient medical and partial surgical cases.


He says that while the introduction of health insurance schemes in both Nigeria and Kenya should be welcomed, the reality is that currently neither is working optimally, due in part to rising costs and inefficiencies in medical delivery. “The escalating cost of healthcare is one of the biggest challenges of properly funding viable medical benefits in both Africa and globally. This is often as a result of the rising cost of provider fees and importation of medical equipment and drugs. The South African government has already highlighted these problems and it is something that does need to be addressed in order to ensure the viability of NHI.”


Olajumoke says that while it is a challenge to determine how best to resolve the issue of provider fees, one positive is that South Africa can learn from the mistakes that have already been made by other countries and also identify what has worked to ensure that its own NHI model works optimally from the outset. A possible initiative by the government could entail working closely with the private sector (including the top medical schemes) to upgrade the inefficient medical facilities in the country.

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