NCOP
FOR WRITTEN REPLY
QUESTION NO. 480
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 October 2011
(INTERNAL QUESTION PAPER NO. 32)
Mr H B Groenewald (DA-NW) to ask the Minister of Health:
(1) With reference to his departmentâs booklet titled, National Health
Insurance â Health Care for all South Africans (details furnished),
(a) what are the consequences for the private sector if the Government
will no longer provide tax subsidies for medical scheme contributions
and (b) how many persons are expected to lose their jobs as a result
of this;
(2) (a) what health subsidies does the Government currently provide and
(b) what is the difference between a (i) subsidy and (ii) rebate;
(3) with reference to a certain statement from the said booklet (details
furnished), (a) what is the wide range of services and (b) what
studies have been conducted that support the claim, âSatisfy your
needsâ?
CW582E
REPLY:
1) (a) Government has a finite amount of financial resources to
support the delivery and provision of quality health services to
the entire population, irrespective of their socioeconomic
status or other such factors. The tax subsidy that Government
provides to members of medical schemes is primarily enjoyed by
the relatively well off sections of the population, including
yourself and your family Honourable Member, with no such benefit
going to the poor and the indigent. This is despite the fact
that these are the people that need healthcare the most.
Therefore, at an appropriate time Government will need to
reconsider whether it is fair that such a subsidy is provided to
the well off and not the poor, and how best these financial
resources can be redirected towards funding the National Health
Insurance.
(b) It is not clear to me why you reason that when the state fails
to help the poor and not only the rich, people must suddenly
lose their jobs. Why donât you ask how many poor people lose
their lives as a result of not enjoying the generous subsidy
which you are enjoying from the state.
2) (a) Government provides a number of health subsidies, at
different levels or amounts, to individuals that fall within
particular income categories. These subsidies include capped
allowance contributions towards medical scheme premiums, post
retirement medical assistance as well as disability or disabled
dependant benefits. The State also subsidises the health
benefits that are provided by statutory entities such as the
Unemployment Insurance Fund and the Road Accident Fund. In terms
of definitions;
(b) (i) a subsidy is a form financial assistance provided by
government as support towards an economic sector. The
intention is generally to prevent an industry or sector
from going into decline. It may also be implemented by
government to relieve pressure on the public sector or to
keep the costs of a given service affordable. On the other
hand;
(ii) a rebate is a refund on taxes. Individuals can get a
rebate on medical expenses, for instance, if the tax they
owe is lower than the estimated taxes that they paid on
medical expenses during a given financial year. The main
difference between the two is that subsidies are generally
prospective while rebates are retrospective.
3) (a) The wide range of services referred to in the departmentâs
booklet implies the comprehensive package of health services
that will be covered by the National Health Insurance as part of
the benefit entitlements for all South African citizens and
legal residents. These services will include health promotion
and preventive care â e.g. vaccines, screening, outpatient
visits to clinics, community health centres and general
practitioners, specialists services, as well as hospitalisation
for basic and catastrophic health needs;
(b) The department will be undertaking pilots that will used to
refine the package of services to be delivered to address the
health needs of the population. Furthermore, to make the system
more responsive to the needs and expectations of the population,
the department has already implemented a number of interrelated
interventions to improve quality of care.
END.