South Africa

NHI is basically dead – B4SA

Joe Phaahla

The government’s National Health Insurance (NHI) scheme will effectively be stillborn as it has no practical funding model, does not pass Constitutional muster, and will be tied up in the courts. 

This is feedback from Business for South Africa (B4SA) Steering Committee Chair Martin Kingston, who told 702 that the NHI is fundamentally flawed and will be challenged in the country’s courts. 

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

Business Unity South Africa (BUSA) and B4SA are preparing to submit a petition to Ramaphosa, requesting that the Bill be referred back to the National Assembly for amendment. 

In its current form, the business groups said the NHI is unworkable, unimplementable, unaffordable, and unconstitutional. 

“The reality is that if President Ramaphosa signs the NHI into law as it is now, I suspect there are many people that are going to litigate,” Kingston said. 

“It will effectively be stillborn and will not proceed until the courts have applied their minds. We think it does not even pass Constitutional muster.”

Kingston explained that the NHI is a critical piece of legislation and should not be rushed through by the government. 

“We support the need, as business, for universal healthcare under the Constitution,” Kingston said. That means the NHI has to comply with the Constitution procedurally and substantively, which it does not. 

Kingston said the Portfolio Committee on Health did not consider any suggestions made by the public, including by the Department of Health and four provincial governments. 

Martin Kingston
Martin Kingston

Prior to the Bill being passed by the National Council of Provinces (NCOP), B4SA and other organisations had already threatened legal action. 

“For the National Assembly and the NCOP to disregard proposed amendments that will have a beneficial and tangible impact on citizens in the interest of rushing the Bill through Parliament is unconstitutional,” Kingston said at the time

“They need to apply their minds carefully and cautiously. We will act in haste and repent at leisure if it is passed now.” 

While B4SA accepts the need for universal healthcare, it believes it must be sustainably funded, provide high-quality healthcare, and be implemented properly after due process. 

When asked why such an important Bill would be pushed through without due consideration, Kingston said it was being used to score political points. 

“It is a fundamental pillar of the election campaign, and they want to demonstrate to the population that they are delivering the NHI,” he explained. 

Kingston also warned that if the Bill is pushed through in its current form, it will be tied up in the courts for decades. 

“If it goes forward as it is currently being proposed, then no doubt, not only ourselves but several other stakeholders from civil society and the private sector will engage with that process.”

“There will be litigation, which serves nobody any useful purpose.”

Litigation will cause further damage to the country’s economy by increasing uncertainty and investor anxiety.

“As a country, at our peril, will this Bill be rushed through. For something as important as this, we are running the risk that the uncertainty it creates will stop people investing in South Africa at a time when it is critical they do,” Kingston said.


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