While the ANC and its coalition partner, Cosatu, welcomed the introduction of the National Health Insurance (NHI) Bill to Parliament on Thursday, opposition parties were less than impressed.
The chairperson of the portfolio committee on health, ANC MP Sibongiseni Dhlomo, welcomed the introduction of the bill by Health Minister Zweli Mkhize. He said the bill had not yet been referred to the committee, although it had been tabled in Parliament.
“We need to wait for the parliamentary processes to take place before anything can be done. I commend the minister for tabling the NHI Bill to the speaker of the National Assembly, where it will take its process to reach the committee,” Dhlomo said in a statement.
“We are extremely happy about this move. This is one of the equalisers of society, where those who are poor can get access to good healthcare. It is a public good and addresses issues of social solidarity. We cannot wait to deliberate on the NHI Bill and have it before the committee, so that those who are down-trodden can comment,” he added.
DA MP and spokesperson on health Siviwe Gwarube greeted the bill’s introduction with less enthusiasm. “As anticipated, the bill has not changed much since the first problematic version was tabled during the fifth Parliament,” she said in a statement.
“The bill, as it stands will not in any way, be able to achieve universal health coverage.”
The DA is convinced that instead of being a vehicle to provide quality healthcare for all, the bill will nationalise healthcare, create another state-owned enterprise and be an additional tax burden to already financially stretched South Africans, and that it will completely remove choice for South Africans.
The DA has an alternative policy, which it calls Sizani. It will allocate a universal subsidy for every eligible person in South Africa, irrespective of whether or not they are covered by the public or private health systems.
IFP chief whip Narend Singh said while the NHI will only come into effect in 2026, there have to be identifiable improvements in the healthcare system from now until that time.
“The IFP hopes that the public participation process, which Parliament is constitutionally mandated to proceed with, will bring to the fore the myriad issues plaguing our health care system,” he said in a statement.
“From the basics in healthcare to the high cost of medicine, to holding pharmaceutical companies accountable for inflated costs.” He said there were far too many dilapidated hospitals and infrastructure, broken down hospital management systems, overworked and underpaid healthcare professionals, nursing and community healthcare worker vacancies, and a shortage of doctors.
“We cannot support legislation when the basics are not covered first. Universal healthcare and access for all South Africans is an ideal we must live up to, but our capacity and capability is a prerequisite for such delivery,” Singh said.
“South Africa does not need the NHI now, what we need is to fix what is wrong first before we implement a grand idea with less-than-grand infrastructure and systems in place.”
FF Plus MP and spokesperson on health Philip van Staden fears the NHI will lead to South African healthcare professionals leaving for greener pastures abroad. He said as of yet Mkhize could not explain how the NHI would be funded.
“South African taxpayers will be squeezed even more by the NHI and won’t be able to pay their compulsory contributions to it, medical funds and higher taxes,” he said in a statement. “The FF Plus can’t see how the NHI will save the country’s health services. It will instead destroy South Africa’s health services.”
Cosatu’s parliamentary co-ordinator, Matthew Parks, welcomed the introduction of the bill. “The National Health Insurance remains the best vehicle to usher in universal health coverage,” he said in a statement. “The South African health system is in urgent need of an overhaul in terms of its financing arrangements, management and the ability to deliver quality health care services.”
He said the unequal distribution of health spent in South Africa and the deteriorating state of public healthcare necessitates the implementation of the NHI. “Ours is a society that has no option but to muster the courage, to make resources available, to develop institutions and technical capacity and to mobilise the masses of the people to confront our four concurrent epidemics comprising poverty-related illnesses such as infectious diseases [including HIV/Aids and TB], maternal and child deaths, non-communicable diseases and violence and injury.”