South Africa’s President Cyril Ramaphosa has signed a bill into law that aims to bring universal health coverage to the country. This move is seen as a significant step towards creating a fairer society, especially with an election looming in two weeks, anticipated to be fiercely competitive.
The National Health Insurance (NHI) Act targets the existing two-tier health system. Currently, the publicly funded sector, serving 84% of the population, is strained and deteriorating, while those with private insurance enjoy better healthcare.
Opponents argue that the law is a political strategy ahead of the election, but the presidency denies this. The law intends to gradually reduce the role of private insurance, establish a public fund for free access to healthcare for South African citizens, and regulate fees charged by private healthcare providers.
President Ramaphosa describes the current healthcare system as fragmented and unsustainable, aiming to address inequalities rooted in apartheid. He emphasizes the importance of equality and fairness in healthcare provision.
Critics fear that the NHI will strain public finances further, limit patient choices, and worsen the quality of care. The funding for NHI, including a mandatory pre-payment system and other taxes, will be determined by the National Treasury.
Major health insurers in South Africa support the goal of universal health coverage but disagree with the proposed funding model. They argue that the current economic challenges make it difficult to implement the NHI effectively.
The NEHAWU labor union urges the government to fully support the NHI to ensure proper resourcing. However, the biggest opposition party, the Democratic Alliance, believes the Act does not address fundamental issues in the healthcare system.
Health policy experts suggest that while the legislation is promising, challenges lie ahead due to high unemployment, a small tax base, and public distrust of the government. They estimate that full implementation could take five to seven years.
Signing the law before the election is seen as a strategic move by the African National Congress to demonstrate its commitment to improving healthcare, a vital issue for the electorate.
