File: Government would focus on a set of targeted interventions to improve public healthcare while the new system was being set up.
PRETORIA - A proposed move to universal health coverage in South Africa will be rolled out in stages as the budget improves, a senior presidential aide told Reuters.
The National Health Insurance (NHI) programme will be debated in Parliament soon.
Some opposition politicians and analysts have questioned the affordability and practicality of those changes, given a struggling economy. They say healthcare could suffer if the changes are rammed through hastily.
Responding to that concern, Olive Shisana, special adviser to President Cyril Ramaphosa, said the programme would be introduced in a fiscally responsible manner.
"This government is not going to do something that will collapse the economy," she said.
Spending on NHI would increase from around R2-billion in the 2019/20 fiscal year to R33-billion in 2025/26, Shisana said.
WATCH: NHI in numbers
That expenditure would come on top of the health budget, currently around R220-billion a year.
Government will consider adding a surcharge on personal income tax and a payroll-based tax from 2025/26 to raise the necessary funds. But with struggling state companies such as Eskom also promised bailouts, there will be competing spending priorities.
To keep costs within budget, Shisana said government would focus on a set of targeted interventions to improve public healthcare while the new system was being set up.
Those could include hiring more doctors and improving hospital infrastructure, while later interventions could include changing the mechanism by which general practitioners are paid to take into account the number of patients they serve.
The reform could yet be delayed by court cases.
Some experts have questioned the constitutionality of provisions in the bill governing the role of provinces because it proposes pooling health funds centrally.
WATCH: DA prepared to fight NHI
Others expect private firms to approach the courts if the public health system is unable to provide adequate care.
Shisana said NHI would not be defeated. "Our policy is solid," she said. "It has been consulted for many years. We don't expect major changes."