President Cyril Ramaphosa is expected to sign the National Insurance Bill into law today. Photographer: Phando Jikelo / Parliament of SA
Cape Town - Ahead of President Cyril Ramaphosa signing into law the National Insurance Bill today, opponents have threatened court action to halt its implementation.
On Monday, Ramaphosa’s office indicated that he would sign the contentious bill into law which will, if implemented as envisioned, dramatically change health care – both public and private – in South Africa.
The bill aims to provide universal health coverage by pooling funds to ensure equitable access to health care services.
It will significantly impact both the private and public health care sectors by restructuring the funding system.
Private health care providers will be required to participate in the NHI scheme, which could lead to increased regulation and changes in how they operate.
The government has promised that the NHI is expected to improve access to quality health care for all South Africans, especially those who previously could not afford private health care.
Although Parliament passed the bill in June last year, it was believed that Ramaphosa had delayed its signing into law over concerns about possible legal challenges.
In February, commenting on the bill, the ANC said it strongly supported the bill and saw it as a “vital step towards achieving universal health care coverage”.
“The bill aims to ensure equitable access to health care services for all South Africans, regardless of their socio-economic status.
“By pooling resources and addressing disparities, the NHI will improve health outcomes nationwide. The ANC-led government is committed to implementing the NHI, advancing health equity and socio-economic development,” said the ANC.
But the Free Market Foundation (FMF) threatened to scupper the bill through the courts, stating that it was politically motivated, unaffordable, incapable of delivering better health outcomes, and will infringe on numerous constitutional rights, including the right of South Africans to have access to health care of their choice.
“Only the wilfully blind will not see this as a pure electioneering stunt, with the ANC desperate in the face of their worst electoral performance yet in the May 29 general election,” said the foundation.
Western Cape Premier Alan Winde and his Health MEC Nomafrench Mbombo have also urged Ramaphosa not to sign the NHI into law, citing Section 27(2) of the Constitution, that “the state must take reasonable legislative and other measures, within its available resources, to achieve the progressive realisation of the right to access health care services”.
Winde noted that the national government does not appear to have done this.
Another opponent, the SA Medical Association (Sama) said: “In our various engagements, we have stated our position that we cannot support the NHI Bill in its current form as a viable solution to address the complex health challenges facing our nation.”
Sama said the NHI Bill, as it stands, fails to adequately address the critical socio-economic imbalances and inequities of the past that continue to plague the health system and limit access for the majority of the population. The country was not ready to implement the law primarily because its funding mechanism was flawed, it said.
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