President Cyril Ramaphosa has used his weekly newsletter to the nation on Monday to make a spirited case for the National Health Insurance (NHI) Bill.
Parliament’s portfolio committee on health has been conducting countrywide public hearings on the Bill, which has drawn strong opposition from some quarters, including the Democratic Alliance (DA).
Ramaphosa said the public hearings have shown that there is “broad support for fundamental change in our health care system.”
‘We will not be reckless’
He sought to reassure NHI critics that the government will implement the NHI in a careful and incremental manner.
“We will not be reckless in implementing the NHI. We will implement it in an incremental fashion and aim to cover the whole country by 2025. We will use an affordable approach to progressively move towards a comprehensive NHI environment,” he wrote.
The President said pegging access to quality healthcare to one’s ability to pay for it “is one of the greatest travesties of our time.”
He explained, “South Africa has two parallel health care systems. Around R250 billion is spent annually on less than 20% of the population. This is the section of our population that has access to private medical insurance. On the other hand our country spends R220 billion on rest of the population.”
‘Segregation of health services’
Ramaphosa said this undermines the constitutional right of access to healthcare for all citizens, adding that the NHI is a far-reaching “act of social transformation” that would address this anomaly.
He said while segregation of health services in the 18th century was “on the basis of colonial settler status,” today it is on the basis of who can pay.
Ramaphosa called on the public to support the NHI, adding, “We must move away from a culture driven solely by self-interest and embrace the spirit of ubuntu, meaning solidarity. This is the vision of the NHI. It is the vision of our Constitution.
“We cannot build a prosperous and economically thriving nation if a small minority of our workforce is healthy while the majority is vulnerable to ill-health and disease. In this respect, NHI is as much an economic issue as it is a fight for social justice.”
Ramaphosa’s spirited defence of the NHI has however not fully convinced some sceptics such as political commentator Justice Malala.
In a Twitter post, he wrote, “This is one of the most persuasive pieces on NHI yet written by the President. Who can argue? It’s all true. Heart is in the right place.
“Yet he says not a word on implementation and how this will be different to Eskom, Transnet and so many other inefficient government institutions.”
The NHI Bill proposes to give access to health services to every citizen, permanent resident, refugee and individuals falling into specific categories of foreign nationals “agreed upon” by the health and international relations ministers.
According to its proposals, medical aid schemes will not be able to provide cover for services that are paid for by the NHI and will only provide “complementary cover.”
Critics, such as medical aid scheme provider Discovery, have said limiting people’s options “will seriously curtail the healthcare they expect and demand.”