NHI fund to be vetted along SARS lines.

A sophisticated ‘risk management engine’ will be set up to reduce fraud and corruption when the massive R128 billion National Health Insurance (NHI) fund rolls into gear in 2012. This assurance was given to several worried delegates to the South African Medical Association (SAMA) conference addressing the impending system by Dr Olive Shisana, chairperson of the NHI Ministerial Advisory Task Team. Some delegates pointed to endemic corruption and financial mismanagement in several provincial health departments, some of it involving Health MECs or their Directors General and asked what the plan was to prevent the NHI fund (rising to R375.5 billion in 2025) from being similarly affected. Others alluded to Cosatu president Zwelinzima Vavi’s reference to ‘the predator state’ in describing the current status quo, in spite of President Jacob Zuma’s belated attempt to crack down on all forms of fraud and corruption. Economist Alex van den Heever cited the red flag waved by the International Labour Organisation (ILO), over the governance of social security agencies in which managers were either under-qualified or political appointees, or both. He also said the ANC projections for the administration costs of the fund (R4 billion in 2012 rising to R11 billion in 2025) did not appear realistic when compared with peer country costs or when the added complexity of managed care (R10 billion in 2012 to R45 billion in 2025) was included. ‘Cheetah-like’ NHI will pounce on cheaters Shisana acknowledged that ‘many of you are concerned that too many hands will be getting into this huge kitty’, but said work had already begun on a risk management engine to prevent fraud and leakage. The NHI fund would report directly to the minister of health and be constructed along the lines of the South African Revenue Service (SARS), ‘acting like a cheetah and not an elephant, with all the bureaucracy’. ‘We must be able to act swiftly and pay quickly as a single-payer. NHI fund to be vetted along SARS lines