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卫生常务委员会审查《国家健康保险法案》所面临的挑战和选择的主题分析。

Thematic analysis of the challenges and options for the Portfolio Committee on Health in reviewing the National Health Insurance Bill.

机构信息

Senior Specialist Scientist, Health Economics, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; Honorary Research Associate, Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Principal Consultant, NMG Consultants and Actuaries, Cape Town, South Africa.

出版信息

S Afr Med J. 2022 May 30;112(7):456-464.

Abstract

The Portfolio Committee on Health (PCH) obtained public input on the National Health Insurance Bill from a wide array of individuals and organisations between May and September 2021. The record of these submissions collated by the Parliamentary Monitoring Group provided the source material for this article. The concerns, suggestions and other issues raised by respondents were analysed to determine what challenges and options the PCH needs to take seriously as they prepare the Bill for Parliament. Prominent issues raised included concerns about the proposed governance structure, flaws in the funding model, the risk of corruption, the constitutional and human rights at risk, limited access to care for several groups, and the unresolved nature of the medical benefits to be provided under the Bill. Future legal contestation of the Bill on several of these issues has the potential to stop or delay its implementation for a long time. The PCH has some hard decisions to make: whether to address these concerns with quite radical revisions of the bill, to omit problematic elements, or to leave it unchanged, and accept the contestation this will bring.

摘要

卫生事务组合委员会(Portfolio Committee on Health,PCH)于 2021 年 5 月至 9 月期间,向众多个人和组织征求了对《国家健康保险法案》的公众意见。议会监督组织(Parliamentary Monitoring Group)整理了这些意见陈述记录,作为本文的资料来源。本研究分析了受访者提出的关切、建议和其他问题,以确定 PCH 在为议会准备该法案时需要认真对待的挑战和选择。提出的突出问题包括对拟议的治理结构、资金模式缺陷、腐败风险、宪法和人权风险、若干群体获得医疗保健的机会有限,以及该法案下将要提供的医疗福利的未决性质表示担忧。未来对该法案的这些问题的法律争议可能会导致其实施长期受阻或推迟。PCH 面临一些艰难的决策:是否要通过对法案进行相当激进的修订来解决这些关切,还是要删除有问题的内容,或者保持不变,并接受由此引发的争议。

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