Ramaphosa set to sign NHI into law

South Africa’s Cyril Ramaphosa is likely to sign off on a controversial health insurance bill before this year’s national elections, according to Khumbudzo Ntshavheni, a minister in the presidency.

“We think it’s a priority that it must be signed during this period so that the full implementation can take place” under the new administration, Ntshavheni said on the sidelines of an annual strategy meeting of Ramaphosa’s cabinet in the capital, Pretoria, on Thursday.

Parliament’s National Council of Provinces approved the National Health Insurance Bill in December and referred it to the president, who can either assent to it or ask lawmakers to amend it if deemed to be legally or technically flawed.

The legislation provides a framework for the provision of universal care through a state-run fund and will ban the private sector from financing treatment covered under the plan. 

While there is widespread support for reform of a system that sees a multi-billion rand private healthcare industry servicing 16% of the population and the balance relying on overburdened public facilities, NHI critics argue that the government’s proposals haven’t been properly costed, are unconstitutional and could be successfully challenged in court.

The cabinet’s strategy meeting precedes the president’s 8 February state-of-the-nation address, his final one before the elections.

The vote – a date for which has yet to be announced – is gearing up to be the most competitive since the end of White-minority rule in 1994, with several opinion polls showing the ruling African National Congress is in danger of losing its outright majority. 

Other matters being discussed at the meeting include the nation’s power crisis, problems faced by the state-owned rail network, crime and the economy.