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By Peter Mothiba

The signing of the National Health Insurance (NHI) Bill into law by President Cyril Ramaphosa last Wednesday has raised emotions of various political parties.

Some parties are wholly in agreement with NHI, while others are completely against it.

At the moment parties like DA and Afrikaaner civil rights movement AfriForum, have threatened to take Ramaphosa to the highest legal arbiter in the country, including the Constitutional Court, if he doesn’t rescind the controversial NHI law.

Some of the reasons espoused by DA and AfriForum regarding their opposition to NHI include disregard of public input in the matter, the exorbitant cost of NHI, denial of the public to health care of their choice, the certain collapse of medical aid schemes, lack of capacity by the government to embark on such a complex programme and the unconstitutionality of the NHI law.

The following are some facts regarding NHI:

1.NHI will cost R300 billion rand a year.

2. Private medical schemes won’t be allowed to offer services which the government can offer in terms of NHI.

3. NHI fund will be supported by payroll taxes from employed workers’ salaries.

4. NHI will pay private health care providers on exactly the same basis it pays health care providers in the public sector and expect the same standard of care from both private and public health care providers.

5. People within the lower income bracket will be able to consult doctors in private practice and also use private hospitals because the NHI fund will pay for such.

6.In order to register for the NHI, people will have to go to designated registration facilities or centres which will be announced when the registration process starts, and they will be issued with NHI cards.

7.Under the NHI scheme, asylum seekers and illegal foreigners are excluded and will only be entitled to emergency medical services and services for notifiable conditions of public health concern.

8. To curb corruption, the fund will have a board in place including the health sector’s anti-corruption forum and the assistance of the Special Investigating Unit.

Here is how various political parties reacted to the signing of NHI into law:


National Health Insurance (NHI) is a crucial social welfare programme that will improve access to health care, especially for those who are vulnerable or disadvantaged as it will reduce the cost of medical expenses on their part.

However, the current government’s handling of the NHI initiative is concerning.

The lack of consideration for key stakeholders’ concerns and potential challenges such as funding, cost sustainability, the potential for increased bureaucracy, administrative burdens, the potential of limited access to certain health services, the impact NHI will have on private health care providers, concern about the quality of care and challenges in implementing a comprehensive system that addresses the complex needs of a diverse population is a major red flag.

Using the NHI as a political campaign tool undermines the programme’s goals and potential benefits.

This will have long-term negative consequences for the country’s health care system.

Issues such as health care infrastructure, staffing and supply chain management can only be effectively implemented by the new Xiluva government.


The PAC welcomes the President’s decision to finally sign into law the NHI Bill.

The PAC views this as a positive step in the right direction in socialising health care and also as a culmination of years of work done by political parties, health care activists and general civil society in lobbying government for the realisation of the constitutionally enshrined rights to health care under Section 27 of the South African Bill of Rights.

The PAC is well aware of the serious challenges facing our health care infrastructure which pose a threat to the successful implementation of the NHI.

However, the PAC maintains that the implementation of proper and quality health care for all should not be delayed while the government still fixes problems within the overall health system of the country.

The guiding question that must be asked is whether we are a society that thinks it proper that some people deserve quality health care over other people, or a society that values each and every human life equally?

The PAC believes we should strive to be the latter.

The signing of the NHI Bill into law shows that we are a society that strives for the equality of all.

One’s ability to pay for medical aid schemes must not mean that they have a greater right to life than those who cannot afford to do so.


The EFF rejects the NHI which has been presented as a solution to universal health care coverage as it is misguided, disingenuous and opportunistic

ANC is using such an important intervention, which is supposed to give all our people dignified health care, for a political score.

The EFF rejects the claim that NHI will usher in universal coverage depending on the private sector which continues to rely on the systemic exploitation of consumers.

The Competition Commission Health Market inquiry has demonstrated that the private health care sector is parasitic and poorly regulated due to the ANC’s incompetence and operates as a law unto itself.

Relying on private health care for universal health care coverage is akin to leaving sheep in the care of wolves.

The EFF maintains that the most practical public health care starts with the decommodification of health care.

South Africa’s health care must shift its focus to primary health care and prioritise preventive measures instead of waiting for people to get sick and treating them later at inflated costs that benefit private hospitals.


Azapo’s view on the NHI matter is that it is a welcome development that will bring about efficient and good health care system that caters for all.

This view is in cognizance of those who are in the lower rung of society, who may not afford high medical costs.

Medical costs are pushed high by greedy pharmaceutical companies and those driven by a desire to make profit.

But the history of the ANC government’s ineptitude and callous attitude towards the welfare of Black people makes Azapo sceptical of the ability of the ruling party to make a success of the NHI programme.

With endless, successive service delivery failures, it is difficult to believe the government and entrust it with billions of rand required to ensure effective implementation of the NHI programme.

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