Timeline

Key Dates and Events

The tabling of the National Health Insurance Bill in a sense signals an important point in thinking about how reform healthcare financing that dates back to the late 1920s. More recently, the following are key dates and events that coincided with the advent of the democratic era. HASA acknowledges the work of the Parliamentary Monitoring Group in compiling this timeline.

1994

Healthcare Financial Committee

In the early 1990s, several policy initiatives considered either social or national health insurance. The Healthcare Finance Committee of 1994 recommended that all formally employed individuals and their immediate dependents should initially form the core membership of social health insurance arrangements with a view to expanding coverage to other groups over time.

1995

Commission of Inquiry on National Health Insurance

The 1995 Commission of Inquiry on National Health Insurance fully supported the recommendations of the 1994 Committee. A strong case was made for primary healthcare services.

1997

The Social Health Insurance Working Group

In 1997, the Social Health Insurance Working Group developed the regulatory framework that resulted in the enactment of the Medical Schemes Act in 1998. This Act was meant to regulate private health insurance as well as entrench the principles of open enrolment, community rating, prescribed minimum benefits and better governance of medical schemes.

2002

Committee of Inquiry Into a Comprehensive Social Security for South Africa

In 2002, the Department of Social Development set up the Committee of Inquiry into a Comprehensive Social Security for South Africa. The Commission recommended that there be mandatory cover for all those in the formal sector earning above a given tax threshold and that contributions should be income-related and collected as a dedicated tax for health. The Committee also recommended that the State should create a national health fund.

2002

Ministeral Task Team on Social Health Insurance

To implement the recommendations of the aforesaid Committee, the Department of Health established the Ministerial Task Team on Social Health Insurance. The Task Team’s primary mandate was to draft an implementation plan with concrete proposals on how to move towards social health insurance and to create supporting legislative and create supporting legislation and institutional mechanisms.

2009

Advisory Committee on National Health Insurance

In August 2009, the Ministerial Advisory Committee was established and tasked with providing the Minister and Department of Health with recommendations regarding the relevant health system reforms and the design and roll-out of National Health Insurance

2011

Department of Health Policy Paper

n mid-2011, the Department of Health released a policy paper titled “NHI in South Africa” for public consultation.

2012 - 2017

NHI Pilot Projects Rollout

Following release of the 2011 policy paper, an implementation phase commenced in 2012, with its overarching focus being the piloting of health system strengthening (HSS) initiatives; the establishment of the NHI Fund and key institutions; and the moving of central hospitals to the national sphere.

2015

Department of Health White Paper

In 2015, the Department of Health released a white paper titled ‘National Health Insurance for South Africa: Towards universal health coverage.’

2018

National Health Insurance Draft Bill

In June 2018, the Department of Health invited written comments from the public on the proposed draft NHI Bill.

2019

Introduction of NHI Bill Before Parliament

In August 2019, the National Health Insurance Bill was introduced to Parliament and is currently under consideration by the National Assembly’s Portfolio Committee on Health. The Bill is going through the stipulated parliamentary processes, including a public participation period (see videos below), before it is put before the National Assembly for a vote. If the National Assembly passes it, it will be referred to the National Council of Provinces (NCOP), for a similar process and concurrence. If the NCOP passes it, it will then be referred to the President who must give assent and sign it into law.

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