Minister of Health Dr Zweli Mkhize published the draft NHI Bill on Thursday (8 August), providing the first details on how universal healthcare will work in South Africa.
The bill states that NHI will be funded by a number of taxes – including a new payroll and personal income tax, and the scrapping of medical scheme tax credits.
Despite these multiple funding sources, experts have warned that the NHI may end up costing more than R256 billion a year – effectively bankrupting the country.
However, Mkhize has rejected claims that South Africa’s economy will not be able to support the proposed NHI.
Speaking to 702, Mkhize said that the NHI is a system that is already operating successfully in a number of other countries.
He added that most of these countries also started their respective national health systems when facing troubled economies.
“We have consulted a number of them and they say you cannot wait until your economy is better before you start, because part of improving the economy is also improving health access to all the people,” he said.
“There (are) already funds that government has voted for which are used for health services. We need to pool all these resources so that the system is structured so that those who are sick can have the level of care they deserve.”
“As we sit today, the private medical sector is spending about R200 billion for only 15% of the population and the government is spending around the same amount. If we put the two together and distribute it in an equitable manner inside the system, it will help more people.”
Not a punishment
Mkhize said that the NHI also shouldn’t be seen as a ‘punishment’ for private medical aid holders or companies.
“It is not a punishment, it is actually equity,” he said. “The country is used to a situation where the privileged can go (to doctors) at the expense of the majority.”
When asked if the NHI should be seen as an additional tax on the richest South Africans, Mkhize said that there is ‘nothing wrong tax’.
“Firstly, there is nothing wrong with tax – all the funds that go to the fiscus is tax.”
“Secondly, the amounts that are going to private healthcare include contributions from government, so we must acknowledge that we also have money from the poor subsidising the rich.”
Mkhize said that there is nothing ‘wrong’ or ‘right’ with either the private and public healthcare sectors, but rather that these sectors need to be ‘realigned’.
“It’s not like we are chasing money just from the one and giving to the other. The reality is that the country needs a much more equitable distribution of resources inside the same system.”