NHI should cover the whole country within 5 years: Ramaphosa

President Cyril Ramaphosa has urged the private sector and ordinary South Africans to get behind plans for the National Health Insurance which government aims to roll-out nationally within the next five years.

In his weekly open letter to the nation, Ramaphosa said that the recent parliamentary hearings around the NHI Bill show that there is broad support for the changes as many people still have difficulty accessing healthcare when they need it.

“South Africa has two parallel health care systems. Around R250 billion is spent annually on less than 20% of the population. This is the section of our population that has access to private medical insurance. On the other hand, our country spends R220 billion on the rest of the population.

“This flies in the face of the Constitutional right of access to health care for all citizens regardless of their socio-economic circumstances. It is a situation that cannot continue. It is inefficient and unsustainable. It is unfair and unjust,” he said.

Ramaphosa added that the escalating cost of health care is affecting South Africans from all social strata where it hurts most – in their pockets.

“As the report of the Health Market Inquiry published last year has shown, even those who have private health insurance are buckling under the pressure of rising premiums and shrinking benefits.

“Out-of-pocket payments are on the increase, draining disposable incomes and making it even harder for many to make ends mee,” the president said.


Ramaphosa said that government will not be ‘reckless’ in implementing the NHI and that the Department of Health should prepare adequately for the implementation of the system.

“We will implement it in an incremental fashion and aim to cover the whole country by 2025.

“We will use an affordable approach to progressively move towards a comprehensive NHI environment,” he said.

Ramaphosa further called on the private sector and citizens to mobilise behind the NHI, to see it implemented.

“I call on the private sector to join government in seeing the NHI realised. To transform the health care landscape to make it more efficient, cost-effective and value for money requires that we forge strong public-private partnerships for the delivery of services,” he said.

“We remain committed to ensuring there is effective consultation and engagement with all sector partners at all stages of the process.”

Read: Government asked South Africans what they think about the NHI – here’s what they said

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NHI should cover the whole country within 5 years: Ramaphosa