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National Health Insurance in South Africa
Employer, Union and Civil Society Perspectives on NHITreatment Action Campaign (TAC), SECTION27 and AIDS Law Project (ALP)A document from the AIDS Law Project entitled “Rethinking health reform” has a useful summary of developments in recent years: The document includes a history of the workings of the ANC’s NHI Committee and the DBSA Health Roadmap process. The document deals with the failure of parliament to process the Medical Schemes Amendment Bill in 2008. That legislation would have introduced the Risk Equalisation Fund and provided the enabling legislation for Low Income Medical Scheme options. It has not been resubmitted to parliament as yet. A new organisation, SECTION27, incorporating the AIDS Law Project, was established in May 2010. “SECTION27 is a public interest law centre that seeks to influence, develop and use the law to protect, promote and advance human rights. Our activities include research, advocacy and legal action to change the socio-economic conditions that undermine human dignity and development, prevent poor people from reaching their full potential and lead to the spread of diseases that have a disproportionate impact on vulnerable and marginalised people. SECTION27 is named after section 27 of the South African Constitution, which lies at the heart of our supreme law’s commitment to socio-economic rights. This section, which locates the right to health within a context of mutually supporting and intersecting rights ...” SECTION27 has released ten documents leaked to them on the state of public health in the provinces. The reports were commissioned by the former Minister of Health, Barbara Hogan, in early 2009. However when she was suddenly replaced as Minister, the reports were not released into the public domain. “These reports contain an honest, sobering assessment of the inadequate financial capacity of provincial departments of health ... The findings in these reports reveal fundamental failures in political and bureaucratic leadership, inappropriate financial management systems, inadequate monitoring and evaluation systems, and a failure to plan appropriately for human resources, amongst others.” Economic and Social Rights Review: Regulating private power in health. “On 28 July 2010, the North Gauteng High Court reviewed and set aside regulations purportedly made in terms of section 90(1)(u) and (v) of the National Health Act 61 of 2003 (NHA). As a result of this judgment, the Regulations Relating to the Obtainment of Information and the Process of Determination and Publication of the Reference Price List (the Regulations) and all related acts – including the determination and publication of the annual national health reference price list (NHRPL) – are now invalid. Over 300 delegates from 56 mass-based civil society organisations attended a conference held on 27 and 28 October 2010. “This conference aims to: - Establish closer working relationships and better co-ordination between pro-poor civil society organisations and the trade union movement in recognition of the fact that both are pursuing social justice and that many of our campaigns will benefit from mutual support and solidarity; - Strengthen appreciation in the trade union movement and civil society of the centrality of the South Africa constitution as a mobilising instrument that both legitimises campaigns to continually improve the conditions of the poor and provides for mechanisms to address the needs of the poor through the Chapter 9 bodies, the Courts and other institutions; - Debate COSATU’s economic policy proposals and build consensus on the need for an economic policy that expands the economy and is pro poor, job creating and genuinely redistributive;” See the final statement on the conference, released by COSATU, as reported in section 2.2 See also papers from the conference at: http://www.section27.org.za/2010/11/02/csc/ Amandla! “Taking Power Seriously”Amandla! is published by AIDC which “aims to strengthen the movement for social justice through the production of alternative knowledge and by enhancing the institutional capacity of Peoples’ Media Organisations and the communication capacity of progressive civil society organisations that facilitates a dialogue giving voice to the poor and marginalized locally and internationally.” See articles added to “The NHI Debate” on the Amandla! web-site. A document was published 0n 30 October 2010 entitled: “Beware think-tanks! Corporate think-tanks, free market ideology and the attack on the Right to Health” “As the recent debate on National Health Insurance has shown, the prospects for fundamental reform of the South African health care system represent important opportunities for those concerned about health equity, but also for those concerned about maximising profits from private health care.” “Health-e is a news agency that produces news and in-depth analysis for the print and electronic media. Our particular focus is HIV/AIDS, public health and issues regarding health policy and practice in South Africa.” Health-e partners are:
Health-e “will publish opinion pieces from various stakeholders and experts on National Health Insurance.” See articles added at http://www.health-e.org.za/health/category_list.php?uid=73 The Health-e site focussed on public sector issues for much of the year until the release in late September of the ANC NHI proposal document. This is a useful place to read a variety of opinions and analysis of the document. There are new opinion pieces by Di McIntyre of UCT, Elroy Paulus of the Black Sash, Mike Waters of the Democratic Alliance and Hein van Eck of Medi-Clinic. Hein van Eck’s opinion piece is particularly interesting for new figures on the estimate of the tax subsidy for medical scheme members and how this is now lower than the spend per head in the public sector. This is an important finding as it is a reversal from when the tax subsidy was estimated in 2005. |
Contact Details:Innovative Medicines SA P.O. Box 2008 Tel: +27 11 880-4644 Fax: +27 11 880-5987
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