Government is ignoring all the red flags: CEO
The government’s push to rush through the National Health Insurance Bill (NHI) ignores all the red flags, major legal holes and outcry by the private sector, says CEO of Business Leadership South Africa (BLSA), Busi Mavuso.
Writing in her weekly newsletter, Mavuso said that government seems intent on moving the bill forward, “somehow ignoring that eventually, the whole charade will collapse.”
She added that the lack of outcry over the passing of the bill indicates that many people have simply given up caring about it. The bill is, however, utterly unworkable with an implementation plan and no funding plan.
“They know the emperor is wearing no clothes, but scarcely anyone considers that remarkable. They will go about their business content that this performance will come to an end with South Africa no further down the line in improving access to healthcare for all,” said Mavuso.
The NHI system establishes the government as the sole buyer of medical services in the country, with plans to be rolled out in phases starting in 2026.
It plans to use funds from the NHI Fund to provide healthcare to all citizens, both at private and public healthcare facilities. Although the source of funding for the NHI Fund is uncertain, the government has stated that taxpayers will ultimately be responsible for covering the costs.
According to Mavuso, the NHI has some seriously negative consequences on top of being overly ambitious and unclear.
“The world it envisages – in which almost all of the private healthcare system is shut down and replaced with a government scheme – is impossible.”
“For anyone considering a future exposure to the South African health system, whether as a worker in it, an investor in it, or indeed anyone concerned about their future access to healthcare, this is a blow to confidence,” she said.
The CEO’s view echoes those of many researchers and analysts at large. Peter Attard Montalto, a director at Intellidex, said the bill is bizarre and impossible to implement in any reasonable timeframe, adding that the government is feeding a pipedream.
Mavuso said that the workability of the system is not about how the government is thinking about the NHI, but more about optics.
“It appears to rather be about signalling, in which some parts of government seem to think that putting the bill into our law books will be seen positively by an important constituency, and that is enough,” Mavuso said.
The CEO said that once the bill becomes law, South Africa will enter a painful period which will do no good for the health system or government.
She added that the National Treasury would then be forced to appear to be attempting to find a way to fund it, despite the fact that there are myriad other demands on it for funding that cannot be satisfied as it is.
Ultimately, the health system will be forced to appear to be implementing it, setting up the required boards and committees, despite the fact that its existing facilities are in urgent need of attention and most of them fail to meet basic standards.
“This will be destructive to government functioning as scapegoating breaks out amid frustration with delays. On top of that, there is inevitably going to be a raft of court cases as people and businesses affected take action to protect their rights,” Mavuso said.
The NHI bill is going through the National Council of Provinces. Following this, it will be sent to the president to be signed into law.
“Perhaps it will obtain a dose of realism at these stages,” said Mavuso.
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