NHI not here to make businesses happy: Motsoaledi
Health Minister Aaron Motsoaledi has dismissed criticism of the National Health Insurance (NHI) scheme from the business sector, saying the plan wasn’t designed to make them happy.
Speaking to Newzroom Afrika, the minister hand-waved concerns raised by business groups and stakeholders about the cost and implementation of the NHI and its impact on the multi-billion rand private healthcare and health insurance sectors.
“We are not implementing universal health coverage for business. We are doing it for South Africans—especially the poor ones. They are going to be the beneficiaries,” he said.
The minister said that the department is not establishing the concept for the benefit of businesses, alluding that prominent voices from the sector have displayed arrogance on the policy.
He said it’s a problem that those in the business community believe that because they “have the gold,” they get to “make the rules.”
“Now that they (businesses) are richer than anybody, they (think they) must make the rules for all of us, and we must just follow them without questioning or without complaining,” he said.
The minister said that no country in the world implements programmes like the NHI because the economy is booming and everyone is flourishing—these schemes are implemented because they are experiencing problems.
He emphasised that these schemes and the concept of universal healthcare were established to provide healthcare to the poor, not to keep businesses happy.
“I’m not saying that we cannot come together from all walks of life to discuss this—but I am challenging the view that, because (a view/comment) comes from big business, that’s the okay one; because they have all the gold, they must make all the rules for all of us, and we must follow.”
What compromise?
Referring to the recently published ‘compromise’ option to the NHI, Motsoaledi said that the health department hasn’t heard of it, having only read about it in the media.
The Hospital Association of South Africa (HASA) outlined the proposal last week (2 September), which broadly boils down to mandatory healthcare insurance for all formally employed workers in South Africa.
By making this mandatory, medical scheme coverage would eventually reach 27.5 million people, allowing the government to increase its spending on the remaining population without having to adjust the health budget.
The proposal was put forward by Netcare Chief Executive Officer Dr Richard Friedland, who said that there is widespread concern that the NHI Fund is unaffordable and will take too long to implement, necessitating the exploration of alternatives.
Weekend papers reported that the proposal had received a warm reception from some senior officials close to President Cyril Ramaphosa—however, Motsoaledi said he had not heard anything about it.
“It was not put to us,” he said, adding that he could not track down anyone in his department or the presidency to express a view—hot or cold—on the concept.
The minister also continued to hit back at the media, accusing publications “from certain sectors” of fear-mongering and trying to make citizens angry—particularly over the cost of the NHI.
Motsoaledi has repeatedly lashed out at critics of the NHI, labelling opposition as “hooliganism” and “propaganda”, accusing the media in particular of using apartheid-era tactics to sow discord.
He repeated that the NHI will not cost R1.3 trillion, as some in the medical schemes industry have claimed.
However, it must be noted that neither Motsoaledi nor anyone in his department or the government as a whole has provided any figures to counter this claim. There is still no official costing of the scheme outside of very broad estimates in whitepapers published a decade ago, using outdated figures.
The minister’s recent criticisms of business have also not addressed any of the sector’s concerns or answered any of the most pressing questions about the NHI.
The business sector has continually raised its ire over being ignored by the government in relation to the NHI, and despite promises by the president to engage and get everyone on the same page, this has not yet happened.
Business Unity South Africa (BUSA) said this week that its doors wide open for discussions with the government around the NHI and reiterated business’ willingness to engage with the state on universal healthcare and reform.
“It is only through formal, constructive engagement with the President, Minister of Health and National Treasury, focused on collaboration rather than division, that we will create a healthcare system that is equitable, effective and sustainable for generations to come,” it said.
However, Motsoaledi’s comments and the very public hand-waving of the business sector around the NHI show that the divide between businesses and the government on healthcare is still very much there and may be widening.
This indicates that the only way forward may be through costly litigation over the laws, with the health department already facing a slew of legal challenges which will likely go all the way to the Constitutional Court.
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