The implementation of the National Health Insurance Act (NHI Act) could seriously handicap disabled and sick employees as well as their employers. While this sounds strange, it appears that the Act’s implementation will start a negative spiral. My opinion on this is based on a number of facts.

Gross mismanagement of our public health facilities

The NHI system will be run by the same government that has terribly mismanaged SA’s current national health system on which the NHI system will be founded. South Africans must never forget the shameful role of government in the Life Esidimeni tragedy that unfolded just a few years ago. The deaths of 144 mentally ill patients followed the Gauteng Department of Health's decision to terminate its contract with Life Esidimeni, a private healthcare provider. This is but one stark example of the gross mismanagement of our public health facilities.

Eradication of employer-funded private healthcare

The NHI Act prohibits private medical aid schemes from funding health care services covered by the NHI system. This will force medical aid schemes either to close down or greatly increase their already high membership fees. And millions of workers that are currently on a medical aid (by virtue of the fact that their employer covers a large portion of the cost) will be unable to afford their memberships going forward.

Additional strain on overburdened and dysfunctional public health system

The Act transfers to the NHI system the funds allocated to the medical aid tax credit benefits that medical aid contributors have been getting. As a result of this and the expected increase in medical aid fees, a great many medical aid members, which will be in their millions, will shift over to the NHI system and thus place a huge additional strain on the already overburdened and dysfunctional public health system.

Alternatively, this will force private medical practitioners to charge NHI medical fees. Consequently, many practitioners will shift their practices to countries where they can charge fees decided by them. This will severely deplete our pool of medical doctors.

Exacerbation of slow and poor health facilities

A great many workers use our impoverished public health facilities and frequently receive slow and poor service. This problem will be greatly exacerbated when more and more employees flood to public health facilities. It is my view, based on the above, that our government will be wasting billions on a NHI system that it is predicted to be incapable of running. And I, as a voter have not been deceived into believing that the government will be looking after our health after the election just completed.

The threat to the economy of the NHI Act is so great that organised business and other stakeholders have threatened to take legal action.

The implications of a sicker workforce on employers

The NHI system will further impoverish the public health system by misdirecting the crucial scarce funds needed to provide the basic health services needed by the millions of workers who use public health facilities. This will not only further compromise the health of employees, it will also delay the ability of employees to recover and to return to work. This will severely impact workplace productivity.

Having consistently large numbers of unfit employees is, most unfortunately, likely to motivate employers to want to replace chronically ill or disabled workers with fit employees. However, the law requires employers to turn over every stone in an attempt to retain genuinely ill and disabled employees before considering the drastic step of termination.

Renewed urgency for employers and managers to understand labour law

Now more than ever, employers are strongly advised to ensure that their managers understand and implement the law and how to deal with such cases effectively but in a legally compliant manner, particularly because the law very strongly protects workers who are disabled or unwell.

The innovative video series WALKING THE LABOUR LAW TIGHTROPE provides this knowhow. Its 48 chapters (averaging 10 minutes in length each), can easily be watched at junctures when the manager has time. This engaging and practical video series provides crucial and user-friendly learning through the use of an animated case study that runs throughout the 48 chapter series. Each chapter contains clear and important advice needed by workplace management on the basics of labour law over a very wide range of topics.

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To learn more about this groundbreaking new video series ‘WALKING THE NEW LABOUR LAW TIGHTROPE’ go to www.labourlawvideos.co.za.

Written by Ivan Israelstam, Chief Executive Officer, Labour Law Management Consulting