By Lehlohonolo Lehana.
President Cyril Ramaphosa says there may be different views on how the National Health Insurance (NHI) Bill will be implemented, the reality is that South Africa’s current health care system is unsustainable.
Ramaphosa wrote in his weekly letter to the nation that access to quality, decent healthcare should not depend on one’s ability to pay, noting that the country’s current healthcare “does not serve the poor, does not serve the middle-class and does not serve the country”.
Ramaphosa signed the NHI Act into law last week, which he said would bring the country one step closer towards universal health coverage.
Ramaphosa highlighted that for many years, South Africa had had parallel healthcare systems operating in the country, with about 84% of the population, using public health facilities, while 16% were covered by medical schemes, enabling them to access private health care facilities.
A small percentage of people use both, he said.
He pointed out that some people have claimed that the NHI would signal the end of private health care.
“To the contrary, the NHI aims to use the respective strengths and capabilities of both the private and public health sectors to build a single, quality health system for all,” he said.
Ramaphosa noted that South Africa’s private health sector had “world-class expertise” and was a major source of domestic and foreign investment, saying the public sector also had numerous centres of excellence and was staffed by well-trained, experienced personnel.
The NHI Fund will procure services from accredited public and private service providers for every person in need of health care, he said, and added that the NHI would be a lifeline for millions of poor South Africans whose financial resources would be freed up for other essential needs.
“…it will also alleviate the burden on those who are increasingly paying more in medical aid premiums for increasingly fewer services,” he said.
He explained that while achieving social justice was a key objective of the NHI, efficiency and better resource allocation were equally important.
Government believes that the real challenge in implementing the NHI lies not in the lack of funds, but in the misallocation of resources that he said currently favoured the private health sector at the expense of public health needs.
He said there was a misconception that the private health care sector operated and was funded completely independently of government.
Civil society organisations and political parties are threatening legal action following last week’s controversial signing of the NHI Bill.
Netcare supports the implementation of universal healthcare in South Africa but says that the signing of the National Health Insurance (NHI) Act, in its current form, will only result in delays.
In its interim financial results for the six months ended 31 March 2024, the group acknowledged the need to address inequities in healthcare access and delivery in South Africa while remaining fully supportive of universal healthcare.
That said, the Act in its current form faced opposition from Netcare, medical aid schemes, businesses, members of the public and parliament’s own legal team.
“The Bill was signed without addressing fundamental areas of weakness,” said Netcare.
“Furthermore, significant flaws in the Bill and the legislative processes followed in promulgating the Bill will likely result in the Bill being challenged on numerous fronts, unfortunately leading to further delays in implementation.”
Netcare said that the potential delays in providing universal healthcare could have been avoided if the government had engaged with all the interested parties.
“Nevertheless, Netcare welcomes the President’s statement in which he expressed the desire to work with all parties, albeit after the fact.”
“The concluding phases of Netcare’s ten-year strategy to transform the way we deliver health and care will remain unaffected, and we expect it to further enhance our future participation in the provision of universal healthcare.”