Bazolwa neNHI ezokwenza ama-medical aid ‘izichuse’
WUSLINDILE KHANYILE
ISIKHWAMA somshwalense wezempilo iNational Health Insurance (iNHI) esesisemthethweni sizophendula izinkampani zemishwalense yezempilo ezimele izichuse, nokungakho lezi zinkampani zithi zizothatha izinyathelo zomthetho.
Lesi sikhwama sizokhokhela ezempilo eNingizimu Afrika, sinqume imali ekhokhelwa abahlinzeka ngalolo sizo futhi yisona esizokhethela umuntu ukuthi ulashwa kuphi uma sesisebenza.
Umthetho weNHI, osayinwe wumengameli uCyril Ramaphosa ngesonto elidlule, yiwona futhi ozokhokhela izifo eziningi njengoba uthe izinkampani zemishwalense wezempilo ezizimele zizovunyelwa ukukhokhela kuphela izifo ezimbalwa ezizobe zingafakiwe kulesi sikhwama.
Ngokusho kwalo mthetho, inhloso yawo enkulu wukuphucula indlela okuhlinzekwa ezempilo ezweni ngayo ukuze wonke umuntu athole usizo olufanayo ukuze kuphele ukuthi u-84% womphakathi uthembele kuhulumeni, kuthi u-16% usebenzise ezempilo ezizimele.
Lo mthetho uthi ziningi izingqinamba ngendlela okuhlinzekwa ezempilo ngayo okufanele zilungiswe.
“Izingqinamba okufanele zilungiswe yijoka lemali okufanele ikhokhwe ngabanye abantu ngenxa yendlela engafani okusebenza ngayo umthetho wokuthi akukhokhwa ezibhedlela zikahulumeni, nanokumba eqolo kwezempilo ezizimele; ukuqhela kwezikhungo zezempilo nakho kuyingqinamba okufaka nezindleko zezokuthutha zomphakathi nezezimo eziphuthumayo; ukushoda kwezisebenzi zezempilo eziqeqeshiwe uma ubheka isibalo sabantu ezweni; ukungabi nabahlinzeka ngezempilo kuzo zonke izindawo ezweni njengoba abaningi begcwele emadolobheni; ubuthaka endleleni okuthengwa ngayo; ukuhlukana kwendlela okukhokhelwa ngayo (ezempilo)okunciphisa imali engenayo nokungasebenzi kahle kwendlela okukhokhwa ngayo kuhulumeni nasembonini ezimele,” kusho lo mthetho.
Lo mthetho uthi uzogxila kakhulu ekukhuthazeni nasekuqinisekiseni ukuthi kunezinhlelo zokuvikela izifo emphakathini njengoba kuzoba nabantu ababizwa ngama-ward health agent ukwenza lo msebenzi.
Kuthiwa onke amawodi omasipala azoba nabantu abazohambela imizi befundisa ngokuzinakekela, ukubona ingozi yesifo iseza, ukugwema ukulimala futhi kuzokwandiswa ukuthi ezikoleni izingane zidlale futhi zinakelele imizimba.
Wonke umuntu eNingizimu Afrika kuzofanele ajwayele ukuthi uma edinga usizo lwezempilo uqala emtholampilo nakwezinye izikhungo zezempilo ezibizwa ngama-primary healthcare service.
Kukulezi zikhungo lapho kuzoshiwo khona uma kufanele umuntu adluliselwe esibhedlela noma kudokotela owungoti wesifo esithile. Lena yiyona ndlela okuvele kwenziwa ngayo ezikhungweni zezempilo zikahulumeni kodwa labo abasebenzisa izikhungo ezizimele bayakwazi ukuvele baqonde esibhedlela noma kudokotela owungoti uma bethanda ngaphandle kokuqala emtholampilo noma kudokotela wezifo zonke.
Inhloko ye-public health medicine eNyuvesi yaKwaZulu-Natali uSolwazi uSaloshni Naidoo uthe ongezukufuna ukulandela le ndlela yokulashwa kuzofanele azikhokhele yena noma asebenzise umshwalense wezempilo ozimele.
Lo mthetho uthi isikhwama seNHI sizosebenzisana nodokotela abazimele kanjalo nezibhedlela ezizimele, nokho akucaci kahle ukuthi lingakanani iqhaza elizobanjwa yimboni yezempilo ezimele.
Yize imishwalense yezempilo ezimele isazoba neqhaza kodwa libonakala lizoncipha, nokuyikho le mboni isilebeke ngembaba ukuthi izoya enkantolo iyokhala ngalo mthetho.
I-Board of Healthcare Funders, inhlangano emele ama-medical aid amaningi amakhulu ngaphandle kweDiscovery Health, ithe yize ukusayinwa komthetho weNHI kungeke kushintshe lutho okwamanje endleleni abasebenza ngayo kodwa izothatha izinyathelo zomthetho ukulwa nezingxenye zeNHI ezinciphisa iqhaza lemishwalense yezempilo ezimele.
“I-BHF ayikholwa ukuthi umthetho weNHI indlela oyiyona njengamanje wanele ukuthi wonke umuntu athole usizo lwezempilo ngendlela efanayo. Okukhulu kakhulu, iBHF izothatha izinyathelo zomthetho ukulwa nesigaba 33 somthetho weNHI esiphikisana nomThethosiseko futhi esingekho emthethweni ngenhloso yokuqikelela ukuthi izinkampani zemishwalense wezempilo zizoqhubeka zikwazi ukusebenza.
“Ngokuhamba kwesikhathi umthetho weNHI uzogcina uphendule izinkampani zemishwalense izinkampani ezisetshenziselwa ukwengeza ngazo ukukhokhela ezempilo. I-BHF ikholwa wukuthi lezi zinkampani zibalulekile ezweni futhi kufanele zibambe iqhaza elikhulu ekuhlinzekeni ngezempilo manje nangomuso,” kusho iBHF.
Indlela umthetho osebenza ngayo okwamanje uthi imishwalense yezempilo ezimele kufanele ikhokhele izifo ezingu-270, ezibizwa ngama-prescribed minimum benefit (amaPMB). Lezi yizona zifo okuthiwa zidlange kakhulu eNingizimu Afrika.
Indlela umthetho weNHI obhalwa ngayo, loku kuzoshintsha uma ususebenza ngoba uthi izifo eziningi zizokhokhelwa yilesi sikhwama esisha sikahulumeni bese imishwalense yezempilo ezimele ikhokhele izifo ezingakhokhelwa yilesi sikhwama.
USolwazi uNaidoo, othe uyavumelana nokuthi sikhona isidingo sokuphucula indlela ezempilo ezihlinzekwa ngayo ukunciphisa igebe elikhona endleleni okwenzeka ngayo, uthe iNHI izoqala ngokukhokhela izifo ezithile ezoloku izandisa kancane kancane.
“Mancane amathuba okuthi bazothi beqala bebebekhokhela zonke lezi zifo eziwu-270 okuthiwa zingama-PMB,” kusho yena.
I-Discovery Health, ethe nayo iyakuseka ukusungulwa kweNHI, ithe nokho ikholwa wukuthi ukunciphisa iqhaza lezinkampani zomshwalense ozimele ngeke kusisize lesi sikhwama ngoba azikho izinsiza ezanele ukubhekelela zonke izidingo zabantu baseNingizimu Afrika.
“Ukunqumela abantu ukuthi iyiphi indlela abangasizakala ngayo ezinkampanini zemishwalense ezimele kuzonciphisa usizo lwezempilo abakwazi ukuluthola futhi abalulindele. Kuletha nengozi yokunciphisa amakhono ezempilo adingeka ezweni futhi akuzwakali kahle kubatshalimali basezweni nabaphesheya.
“Okunye okumqoka wukuthi ngokuvimba abantu abanamandla ukusebenzisa imishwalense yezempilo nokubaphoqa ukuthi bangene ohlelweni lweNHI, le ndlela izonswinya ezezimali zikahulumeni okufanele zikhokhelwe abakhokhibentela. Sikholwa wukuthi ukunciphisa amalungelo ezakhamuzi ekuthengeni umshwalense othe xaxa emva kokuthi sebekhokhe esikhwameni seNHI akudingeki ukuze ufeze izinjongo zalesi sikhwama. Kuyobe futhi kuqala ukwenzeka emhlabeni njengoba kuwona wonke amazwe anesikhwama esifana neNHI, izakhamuzi zivumelekile ukwengeza ngomshwalense ozimele, ngisho ekhokhela lezo zinto ezivele zikhona kuleso sikhwama sikahulumeni,” kusho iDiscovery Health.
Le nkampani ithe isazimisele ukubonisana nomNyango wezeMpilo neHhovisi likaMengameli ukuze kubuyekezwe izingxenye zalo mthetho ezishayisana nomThethosisekelo. Nokho ithe uma isimo siphoqa izothatha izinyathelo ukuvikela amalungelo amalungu ayo.
- Ngesonto elizayo Umbele uzobheka izindleko zalesi sikhwama nokuthi sizokhokhelwa kanjani
FUNDA NALAPHA: https://www.umbele.co.za/2024/05/22/umthetho-wenhi-uyingozi-kwezempilo-eningizimu-afrika-kuloba-ubusi-mavuso/
