The future is here: NHI bill report propels South Africa towards universal health coverage

Published Jun 1, 2023


By Benjamin Mogoye

On Friday, 26 May 2023, the Health Portfolio Committee finally adopted its report on the National Health Insurance (NHI) Bill. This marked an unprecedented milestone in the journey towards achieving Universal Health Coverage (UHC).

This ground-breaking decision signifies a historic moment in the relentless pursuit of providing quality healthcare to all citizens, regardless of their socio-economic status.

However, despite this significant progress, it is most concerning that some interest groups continue to mislead the populace about the true objectives of the NHI, and effectively aims to create panic that the new system will somewhat collapse the healthcare system.

This cannot be further from the truth. In fact, it is quite likely that those deliberately distorting the facts are effectively protecting private interests within the lucrative healthcare sector rather than displaying acts of patriotism.

It is important to recognise that healthcare access is an inherent human right, not a commodity to be exploited for financial gain.

Resisting the implementation of the NHI and prioritising monetary interests over the well-being of the people is both unacceptable and unpatriotic.

I will briefly below, contextualise the reasons I believe South Africa can only benefit from adopting the NHI Bill into Law.

An Unjust Distribution of Healthcare Resources

The current healthcare system in South Africa perpetuates inequality and exacerbates disparities in access to healthcare services.

As noted in the NHI White Paper, nearly half of the health spending predominantly benefits only 16% of the population covered by private medical schemes (NHI White Paper, 2017). This unequal distribution leaves the remaining 84% of the population relying on the remaining funds, resulting in concentrated resources in the private sector.

Such financing disparities have contributed to “a health system favouring a few, with total expenditure for the insured population being from 4.5 to 6 times higher than for people who only use publicly-funded health services” (Kutzin, 2013).

Achieving this good coverage for privately insured customers comes at the expense of the rest of the population, which is at odds with the objectives of universal health coverage (Kutzin, 2013).

Another issue of concern is that, despite better coverage, privately insured South Africans spends six (6) times more on healthcare than the average among Organisation for Economic Co-operation and Development (OECD) countries (HMI, 2019).

Thus, privately insured citizens suffer high out-of-pocket (OOP) expenses, which the NHI seeks to address by ensuring free access at the point of care to mitigate against financial hardship.

A Commendable Milestone by the Portfolio Committee on Health

The adoption of the NHI Report by the Portfolio Committee deserves recognition and demonstrates unwavering dedication and commitment to address the healthcare disparities that have plagued the nation.

This will facilitate a transformative shift towards a more equitable healthcare system.

The adoption followed a protracted but highly democratic process involving public consultations, clause by clause deliberations and the A-list and B-Bill considerations and adoption.

This has now set the stage for the Bill to serve before the National Assembly, after which it will go to the National Council of Provinces and finally to the President for assent into a law of the country.

The Destructive Role by the Opposition

Regrettably, a few opposition parties and interest groups stand in opposition to the noble pursuit of universal health coverage, prioritising cheap politicking and profit-driven interests over the well-being of the people.

Instead of supporting a comprehensive healthcare system that caters to the needs of all citizens, they engage in fearmongering tactics and resort to threats of legal action.

It is essential to emphasise that the NHI is not a thumb-suck, but rather a proven health financing approach supported by the World Health Organization (WHO).

Several countries such as United Kingdom, Australia, South Korea have implemented universal health coverage with great success.

A Call to Unite for the National Health Insurance

In the face of opposition, it is imperative for all patriots and advocates of social justice to rally behind the national health insurance.

We must reject the fear-mongering tactics and misinformation spread by those who prioritise their financial interests over the health and well-being of the population.

Universal health coverage is a moral imperative, and South Africa has the opportunity to lead the way in creating a healthcare system that upholds the principles of equity and social justice.

The adoption of the Portfolio Committee's report on the NHI Bill represents a historic milestone in the journey towards achieving universal health coverage.

It signifies the country’s unwavering commitment to ensuring that every citizen has access to quality healthcare, irrespective of their socioeconomic status.

The unjust distribution of healthcare resources in the current system is undeniable.

It is quite evident that the private health sector has not managed to move us closer towards universal coverage.

A concern with only members of a particular scheme is not a universal coverage approach, as universal means universal (Kutzin, 2013).

The NHI aims to rectify this by ensuring that healthcare is no longer a privilege reserved for the wealthy, but a right extended to all citizens.

It is therefore imperative that we as patriots rally behind the NHI, recognising it as a crucial step towards a more equitable and just society.

By doing so, we can create a healthcare system that truly serves the needs of all citizens, ensuring that no one is left behind in their pursuit of a healthy and fulfilling life.

* Kgaile Benjamin Mogoye is a HPCSA Registered Medical Scientist, working as a National Health Insurance Manager for the National Health Laboratory Service. He writes in his personal capacity.

** The views expressed here are not necessarily those of Independent Media.