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Back 07 Jun, 2024 - Medihelp


NHI: Ten critical questions answered

NHI: Ten critical questions answered

Read our answers to ten critical questions on the National Health Insurance (NHI).
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  1. Does Medihelp put the rights of investors above those of members?
    Medihelp Medical Scheme is not listed on the Johannesburg Stock Exchange (JSE). Our members are our only shareholders and our highest priority. In the end, Medihelp belongs to its members.

  2. What are the biggest unanswered questions about the National Health Insurance (NHI) Act?
    There are multiple issues that have been raised by different stakeholders. These include:

    • What will happen to healthcare professionals if they can only work for the NHI?
    • What will the incentive be for them to stay in the country and work at fixed rates set by the NHI?
    • If the NHI allows healthcare professionals to charge higher fees than the fees paid by the NHI, how will this shortfall be funded?
    • If healthcare professionals are restricted to NHI rates, how will the risk be mitigated that these professionals will pursue patient volumes instead of quality of care?
    • Where does the risk for medical negligence lie, and who will be responsible for compensating injured parties?
    • The question remains, how will the NHI’s prices be determined?
  3. Will the NHI take Medihelp’s reserves?
    The NHI has absolutely no access to Medihelp’s accumulated reserves, as the reserves belong to you, our members. Our legal advice confirms that the Scheme’s funds are safe and cannot be appropriated by the state.

  4. How will the NHI be funded?
    There is no clarity on how the NHI will be funded, only that funding will come from taxes. Analysis indicates that the NHI will need an additional R200 billion in funding. This would require significant changes to tax policy, which the fiscus cannot necessarily accommodate, for example:

    • Collecting R200 billion through VAT would require a 6,5% increase in VAT from 15% to 21,5%.
    • Collecting R200 billion from personal income tax means that tax rates would have to increase by 31% across the board. Each taxpayer would have to pay almost one-third more than their current tax payments, which would massively erode people’s take-home pay.
    • Collecting R200 billion as payroll tax would require a collection of around R1 072 per employee per month. This increases to roughly R1 565 per employee per month, and that is only for those employed in the formal sector.
  5. What does the NHI mean for Medihelp?
    Even though the president signed the Act, it has not been made operative. The president must implement the Act or sections thereof by proclamation. This has not happened yet, and there is currently no indication of when or how it will be implemented. What we do know is that the Act has been a long time coming. The signing of the Bill on 15 May 2024 marks 30 years since the first formal tabling of recommendations in this regard in 1994. At Medihelp, it is business as usual, and nothing has changed!

  6. Should I cancel my medical aid?
    Absolutely not. It is prudent that you don’t cancel your membership to ensure uninterrupted access to quality and affordable healthcare.

  7. How will the NHI affect membership contributions and tax certificates?
    We have seen talks of possible increases in income tax, payroll tax, or changes to VAT. All of this is influenced by the economy, other legislation (for example, the so-called Money Bills), and how much funding is required. It is still unclear at this stage, as the discussion about the funding for the NHI continues to unfold.

  8. When will the NHI be fully implemented?
    There is no indication yet on when the NHI will be implemented, but if we look at the long road it has come so far, it seems that the NHI is still a far way off.

  9. Will Medihelp go to court over the NHI?
    Medihelp is monitoring the NHI Act, related processes, and litigation already launched by various industry role players to oppose initiatives that infringe on our members’ rights. Following discussions with key industry stakeholders, we are evaluating our options in approaching this as a collective. We will always act in the best interests of you, our members.

  10. What can members expect from Medihelp going forward?
    Our continued and unwavering commitment to serving you, our members, as we have for the past 119 years, to ensure quality healthcare services.


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