No money, no plan, and no clue for NHI in South Africa

Vestact founder Paul Theron said the government has “no money, no plan, no clue” for implementing National Health Insurance (NHI) in South Africa and the scheme will not work.

Theron’s comments come after President Cyril Ramaphosa and South Africa’s newly appointed Health Minister Aaron Motsoaledi confirmed that they plan to proceed with implementing NHI.

This came as a surprise to some, who thought the ANC’s loss of majority in the general election and establishment of a Government of National unity this year may change its plans for implementing NHI.

However, President Cyril Ramaphosa reiterated the government’s plan to establish NHI in South Africa at his recent Opening of Parliament Address. 

“An important task of the next five years is to ensure that we also reduce the high cost of living by ensuring that everyone in South Africa has equal access to equitable, accessible, and affordable quality health care,” the President said.

“As we implement the National Health Insurance, we will focus on strengthening health care infrastructure, improving training of health care personnel and using technology to improve health care management.”

Motsoaledi also voiced his support for the legislation in a recent address, saying that the NHI Act is imperative and must be implemented.

While some believe South Africa isn’t ready for NHI and others consider it unaffordable, it is, in fact, “a health-financing system which is meant to be an equalizer between the rich and the poor”, the minister said. 

“If you want to see what inequality means, come to the health sector in South Africa. We can no longer, with our eyes open, sustain such gross inequality.” 

The ANC’s determination to push the legislation through came amidst widespread criticism of the government’s plan.

Chief among these concerns is the lack of a funding mechanism for NHI in South Africa.

A Bureau for Economic Research report found that the country’s current healthcare budget would need to almost double to fund the scheme.

This is a tough ask for a country that has run overall fiscal deficits for over a decade and an already overburdened taxpayer.

Theron told Daily Investor that the government’s plan won’t work. “The ANC doesn’t have a majority in parliament to enact the enabling legislation. They also have no budget for wild dreams,” he said.

The second-largest party in the Government of National Unity, the DA, has always staunchly opposed the ANC’s NHI plan.

When the Bill was signed into law earlier this year, the DA vowed to “challenge the ANC’s NHI all the way to the Constitutional Court”.

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

DA leader John Steenhuisen added that the party will “not stop there”. 

“I furthermore pledge today before the nation that if this country elects the DA into national government on the 29th of May, we will immediately repeal the NHI Bill and prevent it from destroying this country,” he said.

Several other institutions have also threatened legal action against the government regarding the implementation of NHI.

Cas Coovadia, the CEO of Business Unity South Africa, said that, in response to the NHI becoming law, the organisation would consider its options, including legal action.

On 24 May, trade union Solidarity also filed court papers seeking to overturn the NHI. “Solidarity believes the NHI is unconstitutional as well as being unworkable and unaffordable,” it said.

The government’s NHI scheme has already been dealt one significant legal blow, with the High Court ruling that provisions of the National Health Act that force doctors to register for a “certificate of need” are unconstitutional.

“It deprives healthcare workers as well as healthcare users of choice.”

Theron told Daily Investor he plans to support the legal efforts to challenge the NHI in court by sending money.