Government wants to take away people’s medical aid and healthcare choice

Sakeliga warns that the government’s National Health Insurance Act (NHI) is an absurd proposal which will have devastating economic repercussions.

President Cyril Ramaphosa signed the NHI Act into law in May 2024 before the South African general elections.

The NHI cost the ruling party dearly at the polls, demonstrating its unpopularity among all South Africans.

However, despite the stiff resistance to the proposed NHI, the government is blindly pushing ahead with the proposal.

Last month, Health Minister Aaron Motsoaledi, said that he intends to introduce the Governance Regulations to the National Health Insurance Act.

These regulations will provide for establishing the structures and processes for the fund’s governance.

This includes the appointment of a Board, Board Committees, statutory Advisory Committees and a Chief Executive Officer.

While the government is barrelling ahead with its NHI plans, many stakeholders are challenging it through legal channels.

On 24 July 2024, the Pretoria High Court declared a section related to the legislation’s provision for a “Certificate of Need” invalid.

This section is linked to the National Department of Health exerting more control over where doctors and medical professionals can practice in the country.

Solidarity argued that the requirement of a certificate of need infringes unlawfully on the right of health practitioners to practise their profession.

Solidarity’s challenge is not the only legal battle the government faces in its implementation of NHI.

The second-largest party in the Government of National Unity, the DA, has always staunchly opposed the ANC’s NHI plan.

When the Bill was signed into law earlier this year, the DA vowed to “challenge the ANC’s NHI all the way to the Constitutional Court”.

“Our legal team was briefed months ago already and will file our legal challenge against this devasting legislation without delay.”

Several other institutions have also threatened legal action against the government regarding the implementation of the NHI.

Cas Coovadia, the CEO of Business Unity South Africa, said that, in response to the NHI becoming law, the organisation would consider its options, including legal action.

Sakeliga warning about NHI

Sakeliga warned that the NHI’s outrageous framing attempts to anchor negotiations outside any reasonable window.

It highlighted many problems with the NHI Act, which include:

• There is no money for it – At an estimated R1 trillion per year, the NHI is economically unrealistic and arguably impossible.

• Non-cooperation within healthcare – The NHI is unpopular among healthcare companies, doctors, and patients. This alone would render it defunct.

• Litigation – The NHI Act is legally challengeable on numerous grounds, and several parties are mounting or preparing concerted and complementary litigation from several angles.

• Time – The NHI is not yet in effect, and implementation will likely be very slow, highly inefficient, and face political friction.

Sakeliga said that if the NHI Act was implemented, many professionals would exit healthcare, retire early, or emigrate.

Fewer talented young people will pursue medical careers, and critical staffing shortages will begin to create long waiting lists.

The result will be a dramatic fall in healthcare quality and a chronically overburdened healthcare system.

Another problem is that the state will control citizens’ healthcare, and everyone will become an applicant in a state system.

Private medical aids and insurers would largely disappear, leaving the state to control what healthcare people access and when.

To fund the system, the state will have to significantly increase taxes and put an additional burden on the economy.

Sakeliga warned that the state is intent on eliminating healthcare independence, choice, and competition.

“The NHI threatens to create another Eskom-like monopoly where health-shedding becomes a permanent feature,” it said.

“The National Health Insurance Act (NHI) is a disastrous proposal and must be opposed until it is undone or rendered practically impotent.”