Adrian Gore: An NHI fix can be found

‘I don’t think anyone believes the status quo is acceptable.’ Gore said. “I think everyone’s saying, how do you make this thing operate so that it helps all South Africans.’ 

Discovery South Africa’s biggest health-insurer, is cautiously optimistic that a solution can be found around a contentious health law that could cut coverage for private insurers.

The National Health Insurance bill, which was signed into law by President Cyril Ramaphosa two weeks before the May 29 election, seeks to provide universal access to health care through a centrally managed government fund that buys services from public and private providers. The proposal was signed into law  after years of wrangling.

The law has drawn criticism from players in the private sector who claim it will ban them from providing health insurance to anyone covered by the NHI. The bill doesn’t spell out minimum benefits, show how much the revamped system will cost or indicate how it will be funded, critics said.

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Discovery’s Chief Executive Officer Adrian Gore said he has had a meeting with the government to find a solution to the disagreement over the law. “I’ve got a good faith feeling from that meeting that there’s a desire to find solutions that’s a much better road than conflict and litigation,” Gore said in an interview with Bloomberg.

If implemented, private health insurers like Discovery could lose market share as the law allows them to only pay for products and services not covered by the fund. “The new system would be an equaliser between the rich and the poor,” Health Minister Aaron Motsoaledi said in an address to lawmakers in July.

While the country’s overburdened public facilities currently serve about 84% of the population, the remaining 16% that can afford private insurance have access to world-class treatment.

“I don’t think anyone believes the status quo is acceptable.” Gore said. “I think everyone’s saying, how do you make this thing operate so that it helps all South Africans.”

Discovery’s modeling shows that South Africa will need R200 billion ($11.4 billion) a year in additional funding to make the law’s aim of achieving universal access workable. That would result in a 30% hike in income taxes, and a 70% cut to the benefits private sector members typically enjoy.

“We do not believe NHI is workable without private-sector inclusion,” Gore said at an earlier investor briefing. “We need more funding, we need more doctors, we need more resources, and that’s a key issue.”

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