SA’s Healthcare: Should GNU ditch NHI?

The newly formed Government of National Unity (GNU) should ditch National Health Insurance (NHI) and rather choose healthcare beyond the ballot, especially in the face of a changing political landscape and the necessary reforms to make healthcare more affordable.

During election season, healthcare became big news again thanks to the National Health Insurance (NHI) Bill that was rushed through parliament and signed into law.

Medical aid scheme Profmed Craig Comrie says whether this was merely electioneering or a genuine commitment to the sector’s future remains to be seen.

“The election placed unprecedented emphasis on healthcare, with NHI becoming a focal point on many campaign platforms. However, undue focus on the NHI may have overshadowed other critical aspects of healthcare,” said Comrie.

Comrie believes that the challenges in South Africa’s healthcare system are multifaced, demanding comprehensive strategies that go well beyond one solution. “There are challenges, but there are also solutions to fix healthcare in a post-election South Africa,” he said.

What happens to NHI in GNU?

With a Government of National Unity (GNU) officially in power, the fate of the NHI remains uncertain.

Comrie points out that the success of the NHI will depend on the parties’ ability to align on healthcare priorities and take practical steps towards improving healthcare service delivery.

“A new government brings diverse perspectives, which can be beneficial, but it also requires consensus-building. If the NHI is implemented, it will need clear policy direction and collaboration across political lines. However, there is a possibility and further risk that the essential healthcare reforms, not NHI, also get neglected.”

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How to talk about healthcare in the new political landscape

For healthcare to thrive in the new political environment, it must be woven into the broader policy discourse. Comrie advocates for integrating healthcare discussions into all aspects of governance including economic reforms that drive growth.

“Healthcare should be a constant agenda item and not a consequence of unrealistic policy-making or political promises that inevitably will further harm the electorate. We need continuous dialogue and practical actions to improve the system.”

Reflecting on the election campaigns across multiple political parties, Comrie observes that while healthcare received attention, it was often superficial. “Many parties mentioned healthcare, but few offered detailed plans. We need more than slogans. We need actionable policies.”

Comrie would like to see an election cycle where healthcare policies are backed by research and successful pilot programs that are deeply scrutinised and can be scaled into viable solutions.

“Solutions, such as improving leadership and management in the health system in general while encouraging the development of centres of excellence in the public sector, thereby attracting private paying medical scheme members, will alleviate the pressure on the public purse.”

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Beyond the NHI: Comprehensive Healthcare Strategies

While the NHI is a significant step in our healthcare narrative, Comrie warns it should not be viewed as a panacea for all healthcare ills.

“The NHI is not the only way to achieve universal healthcare coverage and there are other models that could be implemented more quickly and effectively. Funding is not the only challenge. We must consider global best practices and adapt them to our context. That means more rigorous debate is needed.”

Comrie stresses the need for practical measures to improve healthcare In the immediate post-election period. “NHI in its current form will take more than a decade to implement and only if there are additional taxes available to fund this ambitious initiative.

“More immediate intervention and reforms must address current issues like affordability and supply constraints relating to healthcare professionals. Low-cost benefit options in the private sector can also make a significant impact and will remove the demand for primary healthcare pressures from the state in a more efficient manner by directing these high frequency lower cost services that can be accessed at local clinics, GPs and pharmacies in the public or private setting.”

Moving beyond political rhetoric

Comrie says healthcare should transcend political rhetoric. “The health consumer has been ignored in the philosophies and slogans. We need practical solutions and skilled implementers, not just policymakers with pens.

“Empowering healthcare consumers and focusing on preventive care are essential steps forward that do not necessarily get their due attention as healthcare talking points.”

He says to achieve sustainable healthcare improvements, everyone must work together. “We need a health compact, a ‘Healthcare Codesa’, where all stakeholders, including consumers, work together to find solutions outside political agendas.”

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Where to from here?

As South Africa navigates a new government construct, Comrie emphasises the need for a balanced, practical approach to healthcare going forward.

“Dreams of universal healthcare coverage must be matched with action. The people must win, regardless of who is in power.”