Debate rages as Ramaphosa’s NHI Act divides SA

The country’s public and private healthcare system has received a major shake up after President Cyril Ramaphosa finally signed the National Health Insurance (NHI) Bill into law. Pic: Supplied.

The country’s public and private healthcare system has received a major shake up after President Cyril Ramaphosa finally signed the National Health Insurance (NHI) Bill into law. Pic: Supplied.

Published May 18, 2024

Share

The country’s public and private healthcare system has received a major shake up after President Cyril Ramaphosa finally signed the National Health Insurance (NHI) Bill into law.

This has resulted in an avalanche of criticism from the private sector as well as opposition political parties.

While receiving praise, mostly from labour and within the ANC, the medical sector and opposition political parties slammed Ramaphosa, with the DA and AfriForum indicating they will be launching a class action to stop NHI from being implemented.

During his address on Wednesday, Ramaphosa said NHI would ensure universal health coverage for the majority of South Africans who are unable to access quality healthcare due to the skewed two-tier health system, in which a publicly-funded sector that serves 84% of the population is overburdened and run-down, while some people have access to better treatment through private insurance.

“This transformational health care initiative gives further effect to our constitutional commitment to progressively realise access to health care services for all its citizens.At its essence, the NHI is a commitment to eradicate the stark inequalities that have long determined who receives adequate healthcare and who suffers from neglect.

“By putting in place a system that ensures equal access to health care regardless of a person’s social and economic circumstances, the NHI takes a bold stride towards a society where no individual must bear an untenable financial burden while seeking medical attention,“ Ramaphosa said.

Speaking during a media briefing outside Union Buildings while Ramaphosa was signing the bill into law, DA leader John Steenhuisen said the party will be challenging the legislation in the Constitutional Court, as the process to adopt it was not inclusive and unconstitutional.

“The Democratic Alliance will, upon its signing into law by Ramaphosa, 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 devastating legislation without delay.

“We have built up reams of correspondence, including with Ramaphosa himself, that we will enter into evidence to show that the process which led to the adoption of this bill by Parliament disregarded public input, and that the [legislation] itself is flagrantly unconstitutional,“ Steenhuisen said.

Steenhuisen also vowed to repeal NHI once the DA is elected to Parliament in the upcoming elections, adding that it will cost taxpayers over R200 billion to realise NHI.

“To give you an idea of how much extra tax this is, it would be equivalent of increasing VAT from 14% to 21.5%, increasing personal income tax by 31%, imposing an additional payroll tax of R1 500 per month on every working person – or a combination of all of the above,“ he said.

The DA’s sentiments were echoed by Louis Boshoff of Afrikaner civil rights group AfriForum, who said AfriForum was preparing for a class action lawsuit against the government, President Cyril Ramaphosa, Parliament and Health Minister Joe Phaahla for the damage that South Africans will suffer under the unaffordable National Health Insurance (NHI) policy.

“If the head of government is willing to ratify a new law, he is supposed to be well informed enough to defend his decision in public. Yet Ramaphosa is not up to it,” Boshoff said.

Reacting to the signing of NHI into law, the South African Medical Association (SAMA) said even though it supports universal health coverage, it was opposed to the NHI in its current form.

“The NHI [legislation], as it stands, fails to adequately address the critical socio-economic imbalances and inequalities of the past that continue to plague our health system and limit access for the majority of the population.

“While the intention behind the bill to transform SA’s healthcare system and ensure universal coverage for health services is commendable, the implementation strategy outlined lacks the necessary depth and practicality required to achieve meaningful and sustainable change,” SAMA said.

In a statement, medical aids scheme giant Discovery, through its chief executive Adrian Gore, urged all its medical aid members to remain calm, saying medical scheme cover and benefits will not be affected by the new laws “for a long time to come”.

“We understand that President Ramaphosa’s signing of the NHI Act has caused anxiety. However, with full implementation a long way out and many matters still to be navigated, I urge you to focus on the facts. Rest assured that we will do the right thing for you, the healthcare system and for all South Africans,” he said.

The EFF described the NHI Act as misguided, disingenuous and opportunistic, saying it will not solve the health problems it seeks to solve as the country’s healthcare system has completely collapsed.

The Star