Expect conditional NHI audit grant in Budget – by Evan Pickworth Bizcom

A conditional grant may be given in February’s Budget to help fund an audit of health facilities prior to the National Health Insurance (NHI) rollout, according to a tax expert.
Implementation of the new health policy is due to take place over the next 14 years, but expert from Deloitte, Ashleigh Theophanides, said on Wednesday, 25 January, this would likely start with an audit of existing facilities.

“There has been a lot of poor management at healthcare facilities, for example the number of nurses to patients is too low. Money can be saved through a proper management system,” she said.

In SA 8.3% of GDP is spent on healthcare, split 50-50 between private and public, but only 15% of people are in the private sector, so the general aim of the policy is to create more equity. There is a R121.5 billion budget for health, which is lower than the R125 billion mentioned in the green paper on NHI. That amount will grow to R225 billion in 2025.

Theophanides said Treasury was now looking at these numbers in greater detail.

“In the next few months we should get a better idea of the cost. For example, if there is saving in the public sector, there could be saving in the private sector.”

This year has seen the introduction of a tax credit system, and the savings in the system, which see lower salaried people paying less, do allow for lowering in the rebates, according to Theophanides.

But on NHI she cautions that SA “needs something appropriate for SA rather than taking something else and thinking it will work in an SA context”.

“We need an answer for a sustainable health system.”

Raising VAT as a health funding model has met with resistance, but Theophanides says raising individual taxes is equally problematic due to the small tax base.

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