Health Minister Aaron Motsoaledi says the National Health Insurance (NHI) will be compulsory for all South African citizens.
Motsoaledi announced on Thursday that the NHI white paper, which was approved by Cabinet last week, will be gazetted on Friday and that it may be fully operational by 2025.
He said, once the law was passed, it would become mandatory for every citizen to be on the NHI.
When asked whether private medical aid schemes would be absorbed, and if they would be made redundant, Motsoaledi said that all state medical aids would be made redundant, but that the question of private medical aids' future would still need to be answered.
"Now the question, which is also constitutional, if after you belong to NHI, which is mandatory, do you have a right to go and buy another private cover somewhere to use it for things."
"Once the NHI is up and running, what reason will you have to still keep medical schemes? It's what they call a mandatory prepayment of care, that NHI. This means once the law is passed it affects all citizens in the country; they have to belong to it, they don't have a choice."
Motsoaledi has also proposed that government withdraw tax incentives to medical aid schemes, which will go into the NHI fund.
Motsoaledi said the R20bn tax credits were unfair and that the money should be taken away and used to establish an interim fund before the NHI comes into being.
He said the NHI was a good idea as it involved the pooling of funds so that all South Africans could access good quality healthcare, not just a select few.
The pooling of funds would work, more or less, as a medical aid scheme, but there were two major differences between the pooling under NHI and that of medical aid.
"The first difference is that the word all, it says all South Africans, medical aid is selected few South Africans, mostly those who are employed."
He said the second was that all people would have the same medical cover, regardless of their socio-economic status.
As to who would foot the bill, Motsoaledi said Treasury would come up with a system, but that the funds would come from tax.
"In other words, everyone is going to contribute towards NHI. Those people who are unable to [contribute], those are the ones that the state must find a way to contribute for them, and it's not unique for South Africa, that's exactly what Obamacare meant."
The next step will be for the NHI Act to be enacted by Parliament, which will mean that several other Acts, such as the Healthcare Act, will have to be amended. – News24