NHI marches on

South Africa’s government signalled that it is making headway in resolving an impasse over a new national medical insurance plan that critics say will infringe on the rights of patients and healthcare workers and sideline the private sector.

President Cyril Ramaphosa signed off on the National Health Insurance Act less than two weeks before the May elections in which the African National Congress lost the parliamentary majority it had held for the past three decades. 

A 10-party coalition government was formed after the vote and some of its members oppose the legislation, which provides a framework for citizens to secure universal access to health care through a centrally managed government fund that buys services from public and private providers.

The law currently bans the private sector from offering cover for treatment available under NHI.

An understanding has been agreed to drop a provision that would have caused the collapse of private medical-insurance companies, DA leader John Steenhuisen told reporters in Cape Town on Wednesday.

“I expect that the NHI Act will have to have some of its provisions redrafted. This is a compromise that has been reached,” Steenhuisen said.

“We will not be part of the destruction of the private medical aids. If that does happen, then we cannot be part” of the unity government, he said. 

Cape Town-based news website News24 reported on the agreement earlier.

Presidency spokesman Vincent Magwenya told reporters in Cape Town that Ramaphosa is committed to ironing out differences within his administration over the NHI, and “one would not be entirely surprised if an agreement is reached in that regard.” 

South Africa’s overburdened public facilities currently serve about 84% of the population, while the remaining 16% who can afford private insurance have access to world-class treatment.

Opponents of NHI say it won’t remedy the healthcare system’s shortcomings, it is unconstitutional, and the government hasn’t spelt out how much the revamped system will cost or how it will be funded. The Solidarity labour union has filed a lawsuit challenging the validity of the legislation.