Doctor takes to X to reveal why she won’t enrol as an NHI provider

The President made history and signed the National Health Insurance (NHI) bill into law. Picture: Pixabay/Pexels

The President made history and signed the National Health Insurance (NHI) bill into law. Picture: Pixabay/Pexels

Published May 16, 2024


On May 15, 2024, President Cyril Ramaphosa made history by signing the National Health Insurance (NHI) Bill into law.

But South Africans are divided on its impact on the health-care system.

The conversation gained momentum on social media platform X, where user @Sentletse remarked: “I can already foresee some private doctors telling you that they are fully booked or private hospitals saying they don’t have beds when you say you’re an NHI user.”

The comment sparked a broader discussion about what the NHI could mean for health-care providers.

Dr Lerato Masemola, aka Dr Lovelee, shared her perspective on X.

Masemola, a family doctor renowned for educating the public and busting health myths, shed light on what the NHI means for health-care workers.

Known not only for her medical expertise but also for her achievements in health and fitness, having run the Comrades Marathon and climbed Mount Kilimanjaro, she provides a range of aesthetic treatments at her practice.

These include botulinum toxin injections, fillers, chemical peels, and specialised therapies for acne, scarring, stretch marks and pigmentation.

Dr Lerato Masemola, aka Dr Lovelee. Picture: X

Masemola unpacked her insights into the NHI.

She wrote: “Here’s some (not so sensational) facts 🙂

“1. People can’t just call up any doctor & say ‘I’m an NHI user, please see me.’

“That is not how it will work. Drs have a choice to opt-in to be NHI providers … and those who do opt-in will provide the service to those who want to use that option for health care.

“- E.g. I can opt-in to be a provider in the suburb where I work currently.

“- There’s also a limit to the number of patients I can see/have on my book as ‘patients I’m responsible for’ in the demarcated area.

“>>>  See how this will lead to the availability of spaces per day/ week/ month. It’s not the “fault” of the provider to be booked out, it’s the system. Ask the Brits & how that’s working for them (wait times of 6 months or more to see a GP - even to treat basic things that you can’t foresee in advance…).”

— Dr Lerato • Keynote Speaker (@dr_lovelee) May 15, 2024

She went on to say: “If say I’m allocated 5000 patients in a 20km radius of my practice, those patients need to register on the NHI system or physically at my practice and select me as their provider - so I can’t see people who are not ‘my’ patients.

“Medical aids already do this … patients are encouraged to select primary GP drs and see them primarily or they don’t get full benefits.”

In her second point, Masemola clarified that doctors were not required to treat patients under the National Health Insurance (NHI) plan unless they had chosen to take part in it.

President Cyril Ramaphosa has officially signed the NHI Bill into law. Picture: The Presidency

She said doctors who did not opt-in to be NHI providers were not obligated to see patients who are unwilling to pay upfront for services.

The only exception was in life-threatening emergencies, where any doctor at any facility must stabilise the patient before referring them to an appropriate facility.

“This already happens anyway with private hospitals when the patient doesn’t have medical aid. If the patient is dying they won’t turn away.. they’ll stabilise & refer to a state hospital (they aren’t obligated to admit and treat),” she wrote on the X thread.

“So.. it will take a while for everyone to wrap their heads around the NHI thing… but let’s not have an attitude of Doctors are against it / will frustrate users deliberately.”

Masemola explained why she, as a private doctor, has opted not to enrol in the NHI.

“Personally I am not for it because from what I’ve seen so far it doesn’t make sense financially. And we already know how unserious our government is about paying service providers on time. And nna my kids won’t eat.

“The invoice will be paid in 90days just be patient.. (they say they won’t do this but how do I trust that if I go on their history 🤷🏽‍♀️

“I definitely believe in good health care for all. And we have great hospitals and clinics that are just poorly resourced and poorly run because well.. poor governance will do that. So what makes everyone think it will be better ‘just because it’s now NHI’?”

Masemola voiced her concerns about the state of the public health sector, urging the government to address the issues.

“Let the government fix the current mess they have allowed to happen in the public health sector. Let’s see how well that runs, and if it does, trust me, a lot of private doctors, including myself, won’t mind doing regular shifts in government clinics, emergency rooms, or wherever the need is."

She shared her experience of working in emergency rooms within the government sector, highlighting the lack of necessary supplies such as gloves and needles and the issue of being overworked due to under-staffing.

“I used to do ER sessions in government. I stopped coz it wasn’t nice not having the things you need to do your work.. like gloves.. needles.. & being overworked coz of understaffing issues.. meanwhile we apparently need a million ‘ministers in the presidency’ who do nothing much while that money can be used to pay Drs!! 🙃”