Nicola Mawson
Trade union Solidarity has again slammed the National Health Insurance (NHI) scheme, this time hitting out at the government’s advertising of the health plan on billboards, arguing it’s still unaffordable.
According to its calculations, the average personal income tax will have to increase by R37 000 per year. This, said Theuns du Buisson, economic researcher at the Solidarity Research Institute (SRI), is “not only outrageous. It is impossible”.
Solidarity’s figures estimate that the scheme will cost between R660 billion and R1 300bn.
“The government is marketing a pipe-dream, while unemployed doctors in the Eastern Cape are protesting, or while hospitals such as Groote Schuur in the Western Cape can now accommodate only a quarter of the number of internships it had available for training three years ago,” Du Buisson said.
During the Medium-Term Budget Policy Statement (MTBPS) in October, Finance Minister Enoch Godongwana reassured stakeholders about the government’s commitment to preparing for NHI rollout, despite a lack of direct funding allocations for its implementation over the next three years.
Based on the MTBPS documents, the health sector will continue to enhance health infrastructure through sustained allocations in direct and indirect infrastructure grants in preparation for the implementation of the NHI.
However, major funding shifts are not expected in the 2025 medium-term expenditure framework period as the focus will be on developing systems and mechanisms that support this reform, as outlined in the NHI Act of 2023.
It is likely that further details will be provided during the February Budget.
Solidarity’s latest statement is in addition to a chorus of dissatisfaction with the NHI, particularly around it being unworkable.
Discovery CEO Adrian Gore publicly stated, shortly after the law being signed into effect last May, that “the NHI Act is not feasible as it rules out private sector collaboration. We remain strongly of this view and will continue to fight for an NHI that is viable and to the benefit of all South Africans.”
“The NHI will only be workable if it provides universal access to care for all South Africans, while not restricting the rights of medical scheme members… to achieve this requires collaboration between the public and private healthcare sectors, which the Act fails to facilitate on a sustainable basis,” said Gore. Gore said that, to achieve sustainability, more sources of funding for healthcare were needed, not less.
“We need more doctors and healthcare professionals and resources, not less. Importantly, a workable NHI requires the public sector to be strengthened, not the private sector to be weakened. We need both to be strong and working together effectively,” he said.
Business Unity South Africa has previously called for an “urgent amendment” to the NHI Act, stating it was “unaffordable, unimplementable and unconstitutional”.
Netcare CEO Dr Richard Friedland has said private hospitals wished to work with government to find solutions to South Africa’s healthcare problems.
The South African Health Professionals Collaboration has also raised concerns, saying: “We do not believe the NHI is a viable or workable model for achieving universal health coverage.”
Discovery has said it will do what is “necessary” as required regarding any legal challenge to the Act. This year, Solidarity intended to also continue to seek to stop the NHI.
Last July, the Gauteng North High Court ruled that the government could not have the power to determine where medical practitioners may practise, ruling this section that allowed the government to determine this as unconstitutional. The challenge to this part of the Act was made by Solidarity.
Business Report