NCOP
FOR WRITTEN REPLY
QUESTION NO. 481
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 is the package of services a person will expect to receive,
(b) what is meant by the statement âThis package will be
comprehensiveâ, and (c) how does this package of services compare to
the Prescribed Minimum Benefits that medical aids are compelled to
provide;
(2) with reference to a certain statement from the said booklet (details
furnished), what special arrangements are being made in areas where
health facilities are in limited supply while rural facilities are
being upgraded?
CW583E
REPLY:
1) (a) and (b) The wide range of services referred to in the
departmentâs booklet is 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. The package will be
based on the demographic and epidemiological profile of the
population. It will be based on scientific evidence and
services will include health promotion and preventive care
â e.g. vaccines, screening, outpatient visits to clinics,
community health centres and general practitioners,
specialist services, as well as hospitalisation for basic
and catastrophic health needs.
(c) This package of services differs fundamentally from the
Prescribed Minimum Benefits in two primary ways. Firstly, the
package is not defined in terms of a positive list of specific
conditions that will be covered by the National Health
Insurance. Instead, the package is stated as a broad scope of
types of services that will be covered. Secondly, the Prescribed
Minimum Benefits are a very limited number of 25 conditions with
270 Diagnosis Treatment Pairs while the package of care that is
proposed for National Health Insurance will be broader and will
essentially address all conditions that contribute towards the
populationâs morbidity and mortality. Basically, we believe the
PMBs is an inadequate attempt to try to solve the health needs
of the population.
2) The Departmentâs booklet indicates that the package of services that
will be covered by the National Health Insurance will be provided by
appropriately accredited and contracted providers. The special
arrangements that will be considered in certain areas will be to fully
contract general practitioners as providers of a wider scope of health
services rather than just primary care.
END.