Kusuka kwesobunxele uSolwazi Fatima Suleman, uDkt Andy Gray, uNkk Fatima Hassan noNkk Inez Naidu.Ukutholakala Kwemithi Ngaphansi Komshuwalense Wezempilo Wakuleli, iNational Health Insurance (NHI)
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Umhlangano wokucobelelana ngolwazi obanjwe ngezobuchwepheshe muva nje obuhlelwe iHealth Justice Initiative (HJI) ngokubambisana nophiko lwenhlangano yezempilo emhlabeni olubhekelele amakhemisi nokusungulwa kwemigomo elawula ukukhishwa kwemithi nolwazi olutholakala ngokwelapha oluse-UKZN (i-World Health Organization (WHO) Collaborating Centre for Pharmaceutical Policy and Evidence Based Practice in UKZN), kugxilwe ekutheni imithi yokwelapha itholakala kanjani ngaphansi kweNHI- kubhekwa ukukhethwa kwemithi ezosetshenziswa, ukuthi izobiza malini nokuthi izothengwa kuphi. INingizimu Afrika izinikele ekutheni zonke iziguli zithole ukwelashwa okulinganayo ngowezi-2030 uma sekuqale ukusebenza kweNHI kodwa lolu hlelo luphazamisekile ngenxa yokuhlasela kobhubhane nokushoda kwemali.
Kulo mhlangano kubhekwe umthethosivivinyo weNHI osanda kushicilelwa emqingweni kahulumeni waphinde wethulwa ekomotini lezempilo elisephalamende ukuze udingidwe ephalamende. INHI ihlele iphepha lokuqala elinemibuzo engu-17 okumele iphendulwe ngaphambi kokuthi iNHI iqale ukusebenza. Izethulo zenziwe nguNksz Fatima Hassan (obendlalela), uDkt Andy Gray (obekhuluma ngokuthengwa kwemithi, imali ezokhishwa izikhungo zezempilo zikahulumeni ziyithenga kanjani nokuthi izobe ithengwa kuphi), uNksz Inez Naidu (obekhuluma ngokukhethwa kwemithi nokukhokhelwa kwabomkhakha wezempilo ozimele). Ingxoxo ebishubile ngesikhathi kunalo mhlangano igqamise ukuthi kunezithiyo eziningi ezingaholela ekutheni owezi-2030 ushaye kungakenzeki ukuthi iziguli zelashwe ngokulingana.
Ubhubhane lugqamise ukubaluleka kokuthi kube nomkhakha wezempilo onabantu abanamakhono adingekayo, kube khona imali etshaliwe, ukungabikhona kwezimfihlo uma kuthathwa izinqumo mayelana nemithetho elawula ezempilo nokukhethwa kwemithi ezosetshenziswa. Ngokusho kukaNkk Hassan weHJI kunokukhathazeka kodokotela. Uthe: ‘Akukacaci kahle ukuthi imali yokweseka ukuqalwa kweNHI izosebenza ngendlela ehlelwe ngayo nokuthi njengoba imali ishoda njengoba kusanda kudlula iCovid-19, umnotho ushone phansi, kucishwa kukagesi ngenhloso yokuwonga nezinga labantu abangasebenzi liphezulu njengamanje, kunokukhathazeka mayelana nemithi yokulawula izifo ezingamahlalakhona ebizayo iNHI engeke ikwazi ukuyikhokhela.’
UNaidu weDiscovery Health Medicine Unit, uthe iDIscovery inesipiliyoni seminyaka engaphezulu kuka-30 isemakethe ibhekelele impilo yamalungu ayo angu-8.95 million. Ilawulwa umthetho olawula izikhwama zempilo, iMedical Schemes Act nokutholakala kwemithi okubanzi. Uphawule wathi: ‘Umthetho weNHI kuqondwe ngawo ukuthi kube nemithi okulula ukuthi itholakale ngemali engambi eqolo noMnyango wezeMpilo ulawule ukwenyuka kwemali yokuthenga imithi yokwelapha. Kodwa iNingizimu Afrika ayizimele yodwa, emhlabeni wonke imithi yokwelapha imba eqolo. Kubalulekile ukuthi izinga lemithi esetshenziswa kuleli lihambisane nelomhlaba wonke kodwa kubalulekile futhi ukuthi iNingizimu Afrika ibe nezinga layo lemithi ukuze iqinisekise ukuthi wonke umuntu wakuleli uyakwazi ukuyithenga.’
UDkt Sham Moodley owusokhemisi osebenza emphakathini, weseke ukuthi ibe khona iNHI kodwa wathi kuningi okungahambi kahle nokufihlwayo ngayo. Uthe: ‘Ubhubhane luveze ithuba elihle lokuthi sibe nohlelo olusebenza ngendlela efana neNHI. Kodwa akuvezwa konke ngayo mayelana nokuthi imali yeminikelo yasetshenziswa kanjani. Uhlelo iSisonke Project lokuthenga imigomo yeCovid-19 beluphethwe ihhovisi likamgcinimafa, kuze kube manje amanye amakhemishi awakakhokhelwa ngemigomo yeCovid-19 ayinikeza abantu. Uhulumeni akathembekile ukuthi angalulandela ngendlela lolu hlelo.’
UGray wase-UKZN unesipiliyoni seminyaka eminingi ekulawulweni kwemithi, oke wasebenza emkhandlwini olawula imithi, iMedicines Control Council obebuye abe ngumeluleki wesikhungo esigunyaza ukusetshenziswa kwemithi kuleli iSouth African Health Products Regulatory Authority (SAHPRA). Uthe ucabanga ukuthi ngesikhathi sokuqala kweNHI kuzobe kusebenza izinhlelo ezintathu zezempilo kuleli okuzobe kuyiNHI ezobe isetshenziswa yibo bonke abantu ivumela ukuthi usizo lwezempilo lutholakale ezikhungweni zezempilo ezizimele nezikahulumeni. Olwesibili uhlelo lwezempilo olukhokhelwa ama-medical Aids. Olwesithathu uhlelo lwezempilo lukahulumeni oluzobe lubhekelele labo abazobe bengekho ngaphansi kweNHI. Kuzoba kunokukapaka endleleni okuzobe kunikezelana ngayo izidingo, umkhakha ozimele nokahulumeni. Njengamanje kunemibuzo yokuthi lemikhakha izohlanganiswa kanjani kodwa izimpendulo ezikhona mayelana nalokho zincane.’
USolwazi Fatima Suleman wase-UKZN, uthe nakuba iNHI izoqalwa kodwa kudingeka ukuthi kube nohlelo lokunikezela izinhlelo ezikhona kuyo. ‘Njengoba kunezinhlelo ezehlukene, ngabe sikucabangisisile lokho? Eminye imithi iNHI ngeke iyikhokhele ikakhulukazi elawula amahlalakhona ebizayo. Ama-medical Aids asenesikhathi eside ekulolu hlelo lokukhokhela esebenzisa izindlela azenzile zokuxhumanisa iziguli nabakhiqiza imithi okungakakhulunywa ngakho kunalokho sigxile ekutheni isondo aliphenduke.’
Umbhalo: MaryAnn Francis
Izithombe: Zithunyelwe