NHI will be here in 2026

Despite rumblings that Cabinet has rejected the NHI Bill, the health department is adamant that "all is well". Picture: iStock
Despite rumblings that Cabinet has rejected the NHI Bill, the health department is adamant that "all is well". Picture: iStock

DA, civil society point out problematic elements of bill as many in private health sector voice support.

Listening to one speaker after the other – many of them from the private health sector – profess their support for and commitment to government’s highly contentious National Health Insurance (NHI) Bill this week, one would have been hard-pressed to pinpoint who had been against it all along.

This week’s official presentation of the bill and its introduction to Parliament marked the start of a “vigorous” process of public debates and engagements on it.

The introduction of the bill was branded by Health Minister Zweli Mkhize as bringing the nation “one step closer” to realising the goal of universal health coverage.

It’s envisaged that the NHI will be fully implemented in the country by 2026.

That leaves seven seemingly short years to make the radical reforms to the country’s healthcare system that will pave the way for a single-purchaser and payer healthcare system, which will also drastically change the scope of medical aid schemes as we currently know them.

Amendments will also need to be made to at least 11 pieces of existing legislation around healthcare.

However, even as Cosatu, the SA Medical Association, the Health Professions’ Council of SA (HPCSA), the Independent Practitioners’ Association Foundation, the Hospital Association of SA, the Life Healthcare Group, the Board of Healthcare Funders and the SA Medical Technology Industry Association (among many other organisations) professed support for and commitment to at least engage with the “much-needed” bill constructively – there are still some who believe the plan to be “ill-conceived” and “unworkable”.

The Free Market Foundation commented: “The latest iteration of the NHI Bill has confirmed what South Africans have known for more than a decade: that taxes will need to rise to fund the government’s unworkable and unfeasible NHI scheme. During these dire economic times, the NHI tax will be the final nail in the coffin for cash-strapped consumers struggling to make ends meet.”

This comes as it was revealed that the main source of funding for the scheme would be through general tax revenue, and would include shifting funds from the provincial equitable share and conditional grants.

Government would also implement a surcharge on personal income tax as well as a payroll tax on employers and employees.

DA MP Siviwe Gwarube also slated the bill and vowed to oppose its “problematic elements”, adding: “The DA is convinced that instead of being a vehicle to provide quality healthcare for all, this bill will nationalise healthcare, create another state-owned enterprise (SOE) and be an additional tax burden to already financially stretched South Africans.”

Mkhize said there would be “plenty of room for engagement”.

Questions and concerns around the fund being a possible vehicle of corruption and ending up like beleaguered SOEs, such as Eskom, were valid and needed to be faced and answered.

“South Africans must continue to raise those issues because they are real and we must confront them. We need to ensure that we create systems that prevent, detect and act early against corruption. We must not fear corruption, we must fight and dismantle it.

“And the good thing is that there are stakeholders who have no qualms about making government accountable. I want to make the point that for NHI, corruption is a threat but we are armed,” the minister said.

Many South Africans took to social media to voice their concerns about the bill, citing the dire state of state facilities, as well as their worries about taxes increasing and the potential for the impending NHI system to be a failure and waste of public money.

The HPCSA’s president, Kgosi Letlape, shot from the hip when it came to the need to reform the currently imbalanced health sector.

While there have been many who have criticised the NHI, saying it was an infringement of citizens’ right to choose what kind of healthcare they wanted and whether to be on medical aid or not, Letlape criticised the private sector as being a “mafia land” where everyone could create their own codes for procedures, resulting in a lack of uniformity.

“There can be no NHI if there are two statutory funds. If we are creating the NHI as a single fund then there should be clear communication around the phasing out of medical schemes. There also can be no NHI without social solidarity. We need boldness and we need political leadership that says there are no two funds and there should be no apologies about that,” he said.


Do you think the NHI scheme will provide all South Africans with quality healthcare, or will it be just another tax burden?

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