Business willing to make NHI work – BLSA CEO

Business Leadership South Africa CEO Busi Mavuso said the private sector is willing to make the National Health Insurance (NHI) Bill workable if the government is willing to include the private sector.

Mavuso told 702’s The Money Show that the NHI Bill in its proposed form is impossible to implement and would leave everyone worse off.

Currently, the Bill relegates private medical schemes to providing only complementary services not covered by the state.

Many industry stakeholders have voiced their concerns with this system, saying the state cannot provide and fund quality healthcare for the entire country.

“There is no way that in its proposed form [NHI] is actually going to work,” said Mavuso. “As it stands, it will leave all South Africans worse off in a system in which state provision becomes impossible.”

In particular, she is concerned about how the NHI will be funded. Currently, the NHI Bill does not specify how it will be funded, although mention has been made of using increased taxes – in particular, payroll taxes.

However, Mavuso said, “There is no funding plan because funding it is impossible.”

She said the country is already in an environment where the government must borrow R2 billion a day “just to balance the books”.

“We’re not talking about taking this money and investing it in productive assets or anything like that – [this money is] just to make sure that you can do what you need to do on a day-to-day basis.”

In addition, when it comes to increasing taxes, Mavuso is concerned that South Africa does not have a large enough tax base to fund healthcare for the entire country.

Only tax income from the top echelon of South Africa’s tax brackets would be able to fund the NHI, and “that is the same top echelon that is leaving the country because of the dysfunctionality that you see in the South African system”.

“You’re really talking about a total of 5.5 million taxpayers, yet the scheme is talking about 60 million people that are going to be covered.”

“No, the math doesn’t add up – there is no way we are going to be able to do this thing.”

However, Mavuso said the private sector has come out to say it is willing to make this Bill workable.

Currently, the private and public sectors are partnering on three workstreams to address the country’s biggest problems: energy, transport and logistics, and crime and corruption.

Mavuso suggested that the government add a fourth workstream focusing on the NHI to this initiative.

“Because we absolutely agree that you do need universal health coverage as a country, but it can’t be done in this way.”