The bill was tabled in Parliament on Thursday and comes accompanied by a memorandum setting out a timeline for a phased implementation process.

It states that the NHI Fund and its executive authority will in the near future begin to bid for funds from the national budget but also moots new taxation options as a source of revenue, including a surcharge on income tax or a "small payroll tax".

The memorandum further flags the affordability and sustainability of National Health Insurance as a legitimate concern.

"This can best be considered with reference to the nature of the proposed system and the checks and balances that will be put in place to limit unnecessary expenditure increases for supply-side as well as demand-side management."

It proposes placing increased emphasis on preventative and primary health care, contending that most healthcare problems can be diagnosed and treated at this level.

Primary health care must, therefore, be made the foundation of the national health service.

It adds that the state would introduce "a mechanism for ‘gatekeeping’ through a primary health care approach and referral system, where patients access higher-level services on the basis of referral networks" to keep costs down.

The bill seeks to extend free health care to all South Africans, permanent residents and refugees. Asylum seekers will only be entitled to emergency health care.

African News Agency (ANA)