Ukuphakamisa iNHI engeke isebenze ‘wukungabi nazwelo’, kuloba uBusi Mavuso

UYAQHUBEKA umsangano womshwalense wezempilo ezweni lonke i-National Health Insurance (iNHI) yize ubheda unjalo. Into enginesiqiniseko sayo wukuthi ngeke uholele ekuphuculeni ezempilo eNingizimu Afrika. Empeleni kunengozi yokuthi kwenzeke okubheda kakhulu.

Njengoba sengike ngasho phambilini, uma uhulumeni ezimisele ngokuphucula ezempilo, kunezindlela eziningi ezingcono zokwenza loko, njengokubambisana nemboni ezimele osekuke kwabonakala ukuthi kuyasebenza. 

Kunaloko siyaqhubeka nokwenza abantu bakholwe ukuthi iNHI isho ukuthi wonke umuntu uzohlinzekwa ngezempilo ezisezingeni ngaphandle kokubheka ukuthi yinto ezozuzwa kanjani. 

Lokho kwenza ukuthi kuqhutshekwe nokuthi kugaywe ivoti, ikakhulukazi uma kukhulunywa ngokuthi iyiphi indlela ozokhokhelwa ngayo lo mshwalense nomonakalo ozokwenzeka embonini yezempilo ezimele. 

Ngesonto elidlule kushicilelwe “konke okuthinta” iNHI okuthiwa kubhalwe wumNyango wezeMpilo. Bekunokuningi okuhle ngeNHI kodwa kuncane obekushiwo ngokuthi kuzokwenzeka kanjani. 

Lo mqingo ongamakhasi awu-27 unamagama awu-198 achaza ukuthi lo mshwalense uzokhokhelwa kanjani. Ukhuluma ngentela ekhokhiswa abaqashi nezisebenzi ebanjwa emholweni kanti usho isimanga esithi “akufanele (abantu) bagqilazeke ngendlela okwenzeka ngayo uma kuqhathaniswa lena okuyiyona esetshenziswayo”. 

Awusho lutho ngokuthi okuphakanyiswayo kuzodla malini, kuphela nje uthi iNingizimu Afrika isebenzisa u-8.5% wenani lomnotho kwezempilo. 

Unenqwaba yamakhasi akhuluma ngokuthi hlobo luni lwezempilo okufanele lulindelwe wumuntu waseNingizimu Afrika kwezempilo kodwa akukho zibalo ezishoyo ukuthi loko kuzodla malini. 

Akusho lutho ngokuthi izinhlelo ezenziwa zokuzwa amanzi ngobhoko zahluleka zancama futhi ayiphathwa eyokuthi indlela ezempilo eziyiyona azisebenzi kahle. 

Umxazululi wezempilo wakudala uSolwazi uMalegapuru Makgoba wathi umNyango wezeMpilo eGauteng “awunabuholi, awunabo abantu abenele, awunambono” kanti owaseMpumalanga Kapa wathi “awusebenzi nhlobo” futhi “uyichilo”. 

Kepha kunenkolelo yokuthi iNHI ingakhiwa phezu kwesisekelo esinjalo futhi kufanele kwenziwe ngokuhlakaza imboni yomshwalense wezempilo ezimele kuphoqwe amalungu ayo ukuthi angene kulo mshwalense wezwe lonke.

Into ewubhedo kakhulu kuyo yonke le nto yindlela okuthiwa kuzokhokhelwa ngayo. Yize lo mqulu okuthiwa unakho konke odinga ukukwazi uthi le ndlela okuyiyona esetshenziswayo exubile “ayisebenzi kahle” ukholwa ukuthi ukususa ingxenye ezimele yilona khambi lokwenza izinto zisebenze kahle. Ngeke kwenzeke ngaphandle kokuthi kube nemali eningi ezoluxhasa lolo hlelo, le mali okuyiyo ekhona embonini ezimele. 

Enye into ehlekisayo kule nto wukuthi intela ebanjwa emiholweni yabantu iyona ezokwenza konke lokhu. 

Okwamanje, uhhafu wemali esetshenziswa kwezempilo iqhamuka embonini ezimele futhi yiyona eqashe u-79% wodokotela. Kepha wu-16% kuphela wabantu onomshwalense wezempilo ozimele. 

Uma sifuna umshwalense wezempilo ufinyelele kuwona wonke umuntu ngale ndlela oyiyo okwamanje, kungafanele imali esiyisebenzisayo iphindaphindwe kasithupha ukuze kwanele kahle wonke umuntu. Loko kungasho ukuthi kungafanele u-4.3% womnotho osetshenziswa embonini ezimele ube wu-26% womnotho.

Yinto-ke leyo engeke yenzeke kodwa mhlawumbe umshwalense ophunguliwe kancane yiyona into engahlanganiseka. Izibalo zeDiscovery ziveza ukuthi iNHI engatheni izobiza cishe uR200 billion 

ozodinga intela inyuswe okungenani ngo-33% noma iVAT inyuke ngo-21.5% noma kuxutshwe kokubili. 

Kuningi okushiwo yilo mqulu othi unakho konke odinga ukukwazi njengokuthi iNHI izosebenza kangcono kunendlela izinto eziyiyo okwamanje kodwa buphi ubufakazi  baloko?

Ngibona nje imboni ezolawulwa wuhulumeni engezukusebenza kahle nemboni ezimele enezinto eziningi ezisebenzayo, iziguli ziyakwazi ukuzikhethela lapho zifuna khona usizo nezinkampani zemishwalense nabahlinzeka ezempilo.

Le nto yokucabanga ukuthi iNHI ingenzeka ngaphandle kokunyusa intela yinto engekho. Intela ebanjwa emiholweni akuyona into eyenzeka kalula ngale ndlela uhulumeni ofisa ngayo.

Uma inyuka, siyancipha isibalo sabantu abayikhokhayo, ngoba abanye bayakugwema ukuyikhokha kanti abanye bathuthela kwamanye amazwe. Kunabantu abangaphezudlwana kuka-50 000 abahola ngaphezu kuka-R2 million abakhokha intela engu-45% womholo wabo (okuyintela eqala kubantu abahola uR1.7m). Labo ngabantu abayingxenye yalaba abangu-5.5m abakhokha intela kodwa lo mshwalense ukholwa wukuthi kungahlinzekwa bonke abantu baseNingizimu Afrika abangu-60m. 

Labo bakhokhi bentela yibona abazolahlekelwa kakhulu uma sekucekelwe phansi imboni yezempilo ekhona okusho ukuthi bazoba nenye into ezobakhuthaza ukuthi bashiye. 

Isibalo sabantu abakhokha intela ngo-2021 sehla ngo-13% uma kuqhathaniswa no-2012. Abanye baphakamise ukuthi intela ekhokhwa yizinkampani yiyona engawukhokhela lo mshwalense kodwa inzuzo eyenziwa yizinkampani iyahambisana nemali etshalwayo. 

Uma izinkampani zikhokhiswa intela, iyancipha imali ezikwazi ukuyitshala ukukhulisa amabhizinisi, umphumela waloko-ke wukuthi umnotho awukhuli futhi nemisebenzi emisha ayibi bikho.

Sikhuluma nje inzuzo eyenziwa yizinkampani zaseNingizimu Afrika ayikaze ibuyele kweyayikhona ngaphambi kokuwa komnotho ngo-2008 futhi iphinde yaphazanyiswa ukuvalwa kwezwe ngesikhathi seCOVID-19.

Abahlaziyi bathe iyodwa kuphela intela enganyuswa ngaphandle kokuxosha abantu, yilena ebanjwa ezimpahleni. Kungafanele le ntela ewu-15% inyuke mawala, iyikota yayo yonke intela eqoqwayo noma u-6% womnotho. 

Ungqongqoshe wezempilo uDkt uJoe Phaahla usole abagxeka iNHI ngokungabi nozwelo nendaba nabangakwazi ukuthola ezempilo ezinohlonze. 

Iyichaze kahle-ke i-Financial Mail ngesonto elidlule njengoba ithe inkulumo yomuntu “obhibhidlayo”. 

Ukuphakamisa iNHI engeke isebenze yikona ukungabi nazwelo.

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