Health Minister, Dr Aaron Motsoaledi, has praised President Cyril Ramaphosa for announcing that South Africa will continue its plans to establish the National Health Insurance (NHI) this year.
“Mr President, in your State of the Nation Address (SONA) last week, you confronted critics and doomsayers by saying something they believed shall never be said. If I may quote you, Mr President: ‘This year, we will proceed with the preparatory work for the establishment of [the] NHI,’” Motsoaledi said.
The Minister was speaking at Wednesday’s SONA debate where Parliamentarians debated President Ramaphosa’s SONA and discussed the NHI, amongst other issues.
Despite the President’s statements, Motsoaledi noted that some critics continue to express their doubts.
“I have listened to people talking against NHI without even having read the Act, and without understanding it.”
According to the Minister, the NHI or Universal Health Care (UHC) is not a system of healthcare; it is primarily a health financing system.
“It talks about the way a country finances its healthcare, such that people’s socio-economic status is not a determinant of who gets better quality healthcare and who does not.”
He explained that the system is designed to provide UHC, ensuring quality care without causing financial hardship, in alignment with the World Health Organisation’s (WHO) goals.
He believes that it is contradictory for the United Nations Sustainable Development Goals to aim to end poverty while maintaining healthcare financing systems that significantly contribute to poverty.
“NHI is about money that is failing and equitably distributed among the whole population. It is about what every citizen gets from their country for their healthcare needs and not because of their income and/or socio-economic status.
“It is how it was designed and evolved all over the world,” he said on the second day of the Parliamentary debate.
He also referenced the former Director-General of the WHO, Dr Margaret Chan, who once stated that NHI serves as an “equaliser between the rich and the poor.”
The Minister also addressed a common sentiment expressed by some individuals in the country who stated: “I support Universal Health Coverage (UHC), but I do not support the NHI in its current form.”
However, he emphasised that the Act requires a programmatic approach that depends on the availability of financial resources.
“The Act had to be drafted like that because that is precisely the nature of UHC. It is a process that is phased in gradually. There is no country anywhere in the world that did it differently simply because it is impossible to do it otherwise.
“Even the present medical aids in South Africa, which many of you claim are perfect, were phased in gradually over a lengthy period of more than half a century.”
Strengthening healthcare
The Minister also highlighted the need to strengthen existing healthcare systems and construction of new hospitals.
“All the countries in the world who have implemented UHC did so not because they are rich and have a huge tax base. No, the opposite is true. They all started UHC because of a crisis of one form or another. UHC was a means of averting that crisis or at least mitigating it.”
Comparisons were made to other countries like the United Kingdom and Canada, which implemented the NHI during economic crises.
He also responded to big businesses, the media, and other critics of the NHI by stating their claims, that implementing the single-payer system outlined in the NHI Act is unconstitutional, will lead to economic collapse, and will deprive people of their right to choose, are unfounded.
“They believe, wrongly so, that we are the first country to be confronted with a choice between a single-payer system and a multipayer system.”
The debate also touched on broader issues such as gender-based violence (GBV), leadership, and economic development, stressing the need for inclusive growth and job creation through industrial policies and infrastructure development. – SAnews.gov.za
