South Africa

NHI will hurt healthcare in South Africa

Joe Phaahla

The National Health Insurance (NHI) Bill will make healthcare worse in its current form, as limiting private funding will weaken the national system. 

This is feedback from South Africa Health Professionals Collaboration (SAHPC) spokesperson Simon Strahan, whose comments follow the announcement that the bill will be signed into law. 

President Cyril Ramaphosa signed the bill into law earlier this month, which aims to transform South Africa’s healthcare system and achieve universal coverage for health services. 

Parliament’s National Council of Provinces approved the bill in December already and referred it to the president to be signed.

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

However, while there is strong support for the need for universal access to healthcare, many have criticised the government’s plan to ban private-sector funding of treatment and the bill’s unconstitutionality. 

The SAHPC, representing more than 25,000 medical, dental, and allied healthcare professionals, has been one of the strongest critics of the plan to scrap private funding. 

In December, the SAHPC urged Rampahosa to refer the bill back to parliament, arguing that it was unconstitutional and not in patients’ best interests. 

“Our members have made submissions at every stage of the legislative process, dating back to the release of the green paper in 2011,” Strahan said. 

“It is disheartening to see our efforts to contribute to a more robust, workable and patient-centric healthcare system being ignored.”. 

“Where we are now is unprecedented, and we believe that the NHI, in its current form, will reverse, rather than progress, equitable, quality healthcare in South Africa.” 

“We have no doubt that the NHI Bill will be challenged in the courts, and we are currently exploring all our options in this regard,” he said.

Strahan’s comments echo those of the managing director of the Board of Healthcare Funders (BHF), Dr Katlego Mothudi, who said earlier this year that the NHI would worsen healthcare provision in South Africa. 

Mothudi said the private sector has a critical role in advancing Universal Health Coverage (UHC) in South Africa and urged the government to collaborate with it to this end. 

“In this respect, the BHF supports UHC and recognises the NHI as one of the mechanisms towards its progressive realisation,”  he said. 

“However, BHF does not support the NHI Bill in its current form due to the unconstitutionality of several of its provisions, its proposed restriction of medical schemes, and the concomitant loss of economic value that will inevitably follow.”

“The private health funding sector in South Africa should not be sacrificed in favour of NHI,” Mothudi said. 

He argued that the private healthcare sector is a valuable source of jobs, scarce skills, infrastructure, financial investment, and quality healthcare. 

“The value it adds to the economy and the support it provides to the public health sector cannot be underestimated. The bill reduces the role of the private sector, and we want those sections removed,” he said. 

In fact, the NHI Bill weakens the private healthcare system. Mothudi said that weakening any aspect of the private health sector will weaken the national health system rather than strengthen it.


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