NHI dispute sparks rift between ANC and DA in GNU

The fallout between the DA and the ANC in the government of national unity (GNU) over the National Health Insurance poses another threat to the GNU.

Experts believe the ongoing bickering between the two major parties in the 10-party coalition stems from their fundamental ideological differences. The duel has been seen as a class struggle for which the two parties should compromise on the way forward.

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A weekend report said the DA and ANC ministers got involved in a heated debate over the proposed NHI expenditure and prediction that medical schemes would be phased out by 2029, as part of the medium-term development plan.

DA cabinet members reportedly challenged the issue which will be further discussed at the January Cabinet lekgotla.

NHI: Markets vs the poor

According to Prof Ntsikelelo Breakfast, director of the Centre for Peace, Security and Conflict Resolution at Nelson Mandela University, the DA rejected the NHI because it threatens its founding values of liberalism which are a “political programme meant to lay the foundation for capitalism”.

“That is the basis of the thinking of the DA; they are defending the markets,” Breakfast said.

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He said at the heart of the capitalism is the maximisation of profit.

“We are talking about market forces, including the doctors who are practising in the private sector and the accumulation that is done in that space by pharmaceutical companies and so on.

“So now if you look at the NHI, the poor and people in general will be catered for by the government,” he said.

‘Backlash’

When an ANC minister alluded to the phasing out of medical schemes that threatened capitalist accumulation, it caused a backlash from those who make profits out of the situation.

“So you must understand the funders of the DA and also why the party was up in arms during the Covid lockdown and demanded that the economy should be opened.

“The DA is defending the markets and its funders and the NHI is threatening the core of their fundamental values,” he said.

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Breakfast said this is an ideological matter. While the ANC had no binding ideology, in its strategic tactics it espoused the liberation of black people in and Africans in particular and its motive forces were the poorest of the poor, he said.

“The ANC is trying to cater for its constituency and I am sure with the influence of the SACP as well as Cosatu. So it is an ideological matter; it is about contending classes,” Breakfast said.

‘ANC being populist’

Another analyst, Zakhele Ndlovu, a politics lecturer at the University of KwaZulu-Natal, had a different view.

While he acknowledged the fundamental ideological disagreements between the ANC and the DA over the NHI, he said healthcare was safe and working efficiently under private hands, including the medical schemes.

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“Why fix something that is not broken? What needs to be fixed are public hospitals so that they run efficiently, that they are not mismanaged,” Ndlovu said.

By planning to introduce NHI, the ANC was being populist because it knew most people would support the idea. He said the two ideological interests would not work and therefore it was important that the DA and the ANC make compromises.

Ndlovu was adamant the ANC’s leftist policies were flawed because the party was unable to run the state-owned enterprises, never mind healthcare.

“I don’t understand why they keep on insisting that we should go public because when you look at public enterprises, such as Eskom and the SAA, there is a huge mess and the state had to bail them out spending billions of rands.

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“I am not supportive or trusting of the public sector to run things because it failed; it lacks the capacity,” Ndlovu said.

– ericn@citizen.co.za