Health Minister Zweli Mkhize File picture: Siphiwe Sibeko/Reuters
Health Minister Zweli Mkhize File picture: Siphiwe Sibeko/Reuters

SA's political parties divided on NHI Bill

By Siyabonga Mkhwanazi Time of article published Aug 10, 2019

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Cape Town - The National Health Insurance (NHI) Bill has received backing from ANC alliance partners but some opposition parties say it is unaffordable and will cripple the country.

The Minister of Health, Zweli Mkhize, launched the NHI and tabled the Bill in Parliament that the government hoped would be fully implemented in 2026.

It is estimated that NHI will cost R256 billion to implement and the government would ensure universal health coverage for all the people.

Minister in the Presidency Jackson Mthembu said Cabinet fully endorsed the NHI and the Bill and now the matter was in the hands of Parliament.

“There has been engagement and Cabinet would not have okayed this Bill to be in Parliament if Cabinet had not engaged it. There is no question about Cabinet having support for this Bill,” said Mthembu.

The SACP and Cosatu welcomed NHI saying it would fix the healthcare system and benefit the poor. But the DA and IFP said the NHI would cripple the state.

The SACP said the NHI Bill would provide quality healthcare to all South Africans. It said those opposed to NHI want to maintain the two-tier healthcare system in the country.

Cosatu also said the NHI Bill was a step towards the realisation of universal health coverage.

The DA said the bill would create another State-Owned Entity in the fund and put an additional tax burden on already struggling South Africans.

The IFP said the country did not need NHI when the healthcare system was already collapsing. The healthcare system was on its knees and yet the government was not fixing it, said the IFP.

The chairperson of the portfolio committee on health, Dr Sibongiseni Dhlomo, said they were looking forward to engaging on the Bill.

The Bill states a fund will be established to run the programme.

“Actuarial costing model: Treasury commissioned a simplified intervention-based costing tool for 2019/20 which provides simple estimates of costs of a set of 15 or so interventions,” states the Bill.

“These include for example, removing user fees, extending the chronic medicine distribution programme, extending ARV roll-out, increasing antenatal visits, rolling out capitation model for general practitioners, cataract surgery programme, establishing the fund. The full set of interventions costs in the longer term around R30bn per annum. Most of these interventions can be scaled up progressively as funding becomes available and do not need significant new funds in budget 2020,” states the Bill.

The Bill also envisages the employment of more staff. Mkhize had said they have sent 30 district managers to Japan to study NHI. More senior staff will be sent to the UK, France and other EU countries to look at how NHI was implemented in those countries.

The bill states the budget for the NHI fund will progressively increase over the years. They will also shift some of the allocations from other programmes of the department of health to the NHI fund.

“In a later phase, consideration will be given to shifting of funds currently in the provincial equitable share formula for personal health care services (currently the main public health funding stream consisting of around R150bn per annum) to the fund,” states the Bill.

It adds that NHI will be funded through “a surcharge on income tax, small payroll-based taxes as financing sources for the fund”.

“Due to the current fiscal conditions, tax increases may come at a later stage of NHI implementation.”

Political Bureau

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