Azra Hoosen | ah@radioislam.co.za
20 June 2024 | 15:00 CAT
2 min read

The National Health Insurance (NHI) Act, signed into law by President Ramaphosa just before the elections, faces an uncertain future under South Africa’s new Government of National Unity (GNU).

While all five coalition parties support universal healthcare, only the ANC and GOOD explicitly back the NHI Act. The remaining parties, including the DA and IFP, either oppose the Act or have alternative plans for achieving universal health coverage.

Experts highlight that the NHI Act, although now law, requires further legislation and detailed regulations before it can be implemented. The process involves multiple steps, including drafting and approving regulations, public consultations, and final Cabinet approval. This makes the timeline for the Act’s rollout uncertain and potentially very slow.

Mia Malan, Editor-in-Chief and Executive Director of the Bhekisisa Centre for Health Journalism notes that the DA is currently very much against the NHI Act and has an entirely different plan for healthcare.

“It would be interesting to see which party gets the portfolio of Health and position of minister of Health,” she said.

She believes the ANC would want to retain this portfolio; otherwise, there will be many problems with the NHI.

The implementation will be gradual, starting with setting up the NHI Fund’s board and administration over the next few years. The Act’s future depends heavily on the coalition dynamics and the specific parties overseeing the health portfolio.

“The NHI will take a long time to implement. With the GNU, what other parties can do is stall the implementation process. The first step would be for a board to be appointed; without a board and CEO of the NHI fund, the NHI cannot be implemented,” she said.

According to Malan, the private sector has already reacted strongly, with court cases looming. The business community was particularly upset when the NHI Act was signed into law, and media reports indicate that President Ramaphosa will engage with them again.

“Something everyone agrees with is the universal access to healthcare and the same type of healthcare, but in the interim, we can work on improving the facilities, particularly in the public health sector; this needs to happen regardless. And, of course, the private sector is in no way perfect; we need to look at ways to better regulate it whether there is an NHI or not,” she said.

For now, the Act remains more a framework than an actionable plan, and its path forward is fraught with political and administrative challenges.

LISTEN to the full interview with Ml Habibi Bobat and Mia Malan, here.