Health workers are seen at the Nasrec Field Hospital for Covid-19 on 25 January 2021. Picture: Michel Bega
Parliament has passed the controversial National Health Insurance (NHI) Bill, paving the way for universal healthcare in South Africa.
The African National Congress (ANC) used its majority in the National Assembly to vote in favour of the NHI Bill on Tuesday.
The Democratic Alliance (DA), Economic Freedom Fighters (EFF) and Inkatha Freedom Party (IFP) were among the parties that voted against the bill.
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The NHI Bill proposes for comprehensive medical schemes to fall away despite nearly nine million South Africans being a member of a medical aid.
It also proposes that most healthcare – including doctors’ visits and medicines – would be free for everyone and medical schemes would not be able to provide cover for services that were paid for by the NHI.
The bill further states that government would levy an extra tax on citizens’ personal income tax and use the money it will save by not giving tax credits for being a member of a medical scheme.
Before the vote, MPs debated on the proposed legislation, with Health Minister Joe Phaahla lamenting the imbalance between the public and private healthcare sectors.
Phaahla said the bill was seeking to stop “two trains on parallel tracks” from crashing.
“This has led to a situation where the public health system is under tremendous pressure while the private healthcare is over-servicing its clients leading to ever rising costs to the members of medical scheme while the investors are enjoying huge dividends.
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“The reality is that this situation is not sustainable as the number of people in informal jobs is not rising in line with the investments in private healthcare. The costs of subscription to medical scheme is rising above inflation every year while benefits are reducing,” he said.
“All medical professionals are trained for their clinical skills on ordinary South Africans in the public health facilities, but once they are qualified they are only accessible to those with money. The availability of top health professionals to those with medical aid, but even migration to other countries is totally unjust.”
DA MP Michele Clarke labelled the bill as “disastrous” as it will destroy South Africa’s healthcare.
“The ANC might argue that through the NHI fund, private health facilities will servicing a large portion of the public previously unable to access their services. However, this is based on the ludicrous assumption that those nine million South Africans will continue to pay their medical aids when it will no longer have any benefit for them.
“Without private patient funding, private health facilities will be dependent on government funding, effectively making them public health facilities without the benefit of a dedicated budget,” she said.
Clarke said she believed the NHI would open the floodgates to corruption, citing the Covid-19 pandemic as an example.
“The NHI is not a miracle that ANC claims it to be. It’s only meant to convince people that the looters have returned to their revolutionary roots, that once liberated a nation.”
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EFF Naledi Chirwa described the draft legislation as “one of the biggest scams” proposed by the ANC.
“The only way to eradicate a two-tier system is nationalisation, not tenderising healthcare,” she said.
Chirwa accused Phaahla of failing to outline the true cost of the NHI, while Finance Minister Enoch Godongwana also did not state how the NHI would be funded.
“The NHI does not make access to healthcare easier for the poor, as there is a referral system that is encapsulation in the NHI which states that we should all access healthcare at our nearest facility.
“This means that those living in townships, rural areas, informal settlements will still be subjected to the public health facilities,” she said.
“The NHI is a direct manifestation of what the Ramaphosa administration truly represents – the fully fledged programme to privatise everything and leave the state useless.”
National Health Insurance Bill b 11 2019 by Molefe Seeletsa on Scribd
IFP MP Magdalena Hlengwa said the bill will deny access to healthcare because of the amount of funding it will require.
Hlengwa warned that the bill, in its current form, will provide the minister of health with powers “beyond the political office”.
“This will open the doorway to undue influence, cadre deployment and negatively impact oversight,” she said.
GOOD MP Brett Herron said his party supported the bill, although it acknowledged the legislation wasn’t perfect.
“The objectives are good. Potential barriers to the NHI’s success, including corruption, must be addressed.”
Following the debate, 205 MPs voted in favour of the NHI Bill, while 125 voted against it.
The bill will now head to the the National Council of Provinces (NCOP), which will open the door for another round of public hearings.
The draft law will then be sent to the president for approval.
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