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South African Dental Journal

On-line version ISSN 0375-1562
Print version ISSN 0011-8516

S. Afr. dent. j. vol.72 n.6 Johannesburg Jul. 2017




SADA Communique



KC Makhubele





The recent approval by Cabinet, and the subsequent gazetting, of the White Paper on National Health Insurance (NHI) attracted considerable media attention. It has also raised many questions and concerns amongst the dental profession.

Whilst these, and the unease of other professions, are acknowledged, the ideal of Universal health care should be embraced and not feared. Admittedly, there are still many questions surrounding the implementations of the NHI, but the solutions cannot be provided by Government alone. The concerted collaboration by all stakeholders will be essential. As healthcare providers, our moral compass guides us to serve and protect our fellow human beings in their times of need, irrespective of their ability to pay for treatment or the limitations of their medical schemes plans. Universal health-care provides exactly that system in which health-care and financial protection are available to all people irrespective of background. NHI is South Africa's answer to the World Health Organization's call for Universal health-care by 2030 as part of the Millennium Development Goals. Our Health Minister, Aaron Motsoaledi intends for the South African NHI to be fully operational by 2025.

Health-care in South Africa has historically been a two-tiered system with only 20% of the country's healthcare providers servicing 84% of the population in the public sector. It is no wonder that state facilities are synonymous with long queues and with an often questionable quality of service. As a nation, universal health coverage is a goal worth fighting for, but it will not be achieved without the support and commitment of the private health-care sector. While it is true that health-care delivery and reimbursement models will have to undergo radical change to ensure equitable access to care for all South Africans, this does not necessarily mean that providers will suffer disadvantages as a result of the changes that need to be made. Once the vast majority of the population secure access to the private sector, it is likely that a greatly increased number of patients will be seen by private practitioners per day ...... which could likely increase earnings, despite the capitation payment models intended for implementation by the NHI. A similar situation was observed in the US with the advent of Obamacare.

The Department of Health has identified the need for dental care amongst school going children as a priority area for the focus of the NHI. We at SADA have been in discussions with the Director General of Health, Ms MP Matsoso, indicating our concern that we have not been adequately engaged as an Association regarding the work around the NHI. We are encouraged that the Department of Health has now invited us to engage with them in the task of defining the basket of services that will be available and at which points of access, as well as contributing to the formulation of the regulations of the Office of Health Standard Compliance (OHSC). The priority will be to encourage Primary Healthcare objectives and preventive and health promotion initiatives, with appropriate referral structures, depending on the level of services then required. We look forward to upcoming engagements with the Department and with the Dental Fraternity as a whole in developing a comprehensive submission that will benefit the entire South African population.

Every member should be ready to play a role in this crucial planning.

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