South Africa

We will do the same to healthcare as we did with the economy – Ramaphosa

President Cyril Ramaphosa said that just as striking workers helped grow the economy, National Health Insurance (NHI) will help improve healthcare.

On Wednesday, Ramaphosa signed the NHI Bill into law despite strong opposition from industry players and other stakeholders.

NHI has been in the works for over a decade. The NHI Green Paper was released in 2011, and discussions about it have been ongoing for years.

The NHI Bill was introduced to Parliament in 2019. Last year, the Portfolio Committee on Health approved the Bill.

The National Assembly and the National Council of Provinces then approved the Bill, which was passed to the President to be signed in December 2023.

The NHI Act aims to transform South Africa’s healthcare system to achieve universal coverage for health services.

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.

Many industry players slated the plan, saying it is an election ploy, unaffordable, and will not deliver better health outcomes.

Another concern is that it infringes on constitutional rights, including the right of South Africans to access healthcare of their choice.

“The NHI Bill in its current form is unworkable, unaffordable, and not in line with the Constitution,” BUSA CEO Cas Coovadia said.

There are numerous organisations which have indicated that they would challenge the newly signed NHI Bill in court.

The DA said it would challenge National Health Insurance all the way to the Constitutional Court.

“Our legal team was briefed months ago and will file our legal challenge against this devasting legislation without delay,” the DA said.

Solidarity said it would start with a legal process against this Bill as it is populist, irrational, and unaffordable.

“If the President signs the NHI Bill, knowing that it contains substantial flaws, he is also responsible for its consequences,” Solidarity said.

“This piece of legislation will be detrimental to all South Africans. To put the country’s health at risk for the sake of votes is extremely reckless.”

Ramaphosa pushing ahead despite legal threats

Ramaphosa dismissed these concerns and legal threats, saying the opposition to NHI comes from well-to-do, rich people.

“This is what often happens. The haves don’t want the have-nots to benefit from what they have been having,” he said.

“We are saying, through NHI, all our people must have equality. There must be equality for all in our country.”

During the signing ceremony, Ramaphosa said there was nothing to fear regarding the NHI Bill.

He referenced the fears of white South Africans when everyone in the country gained the right to vote.

He said many were so terrified that they started collecting tinned food and storing it in their cupboards to prepare for a calamity. “Nothing happened – only progress,” he said.

Ramaphosa added that the right to strike is another example which people feared but helped the country.

“Many employers were fearful that workers will now have the right to strike, which will destroy the economy,” he said.

“Instead, having won the right to strike, we have been able to grow the economy almost threefold since the days of Apartheid.”

“This shows there was nothing to fear. They just feared ghosts.”

He said the same goes for national healthcare. “For those who are fearful, just think about the commitment of the government party to build a sustainable, growing nation.”

“National healthcare on a universal basis is going to build our nation in a very practical way,” Ramaphosa said.

Ramaphosa’s misguided economic claims

However, while Ramaphosa praises “growing the economy almost threefold,” this is actually a devastating indictment of the ruling party’s failure.

An analysis of economic growth shows that all of South Africa’s neighbours, including Zimbabwe, have significantly outperformed South Africa since the ANC took power.

It also shows that all BRICS countries – Brazil, Russia, India, and China – outperformed South Africa.

The ruling party’s poor policies and mismanagement have caused tremendous damage to the economy, as shown in the charts below.


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