The National Health Insurance Act (NHI) will still be implemented, with a preliminary list of public health facilities earmarked for a pilot project for the rollout.
This is despite the contentious legislation being scrapped from the medium-term development plan (MTDP), which is the government’s growth blueprint until 2029. It follows a last-minute deal being struck between the ANC and the DA on the eve of President Cyril Ramaphosa's state of the nation address (Sona) last Thursday.
In a parliamentary debate on the Sona on Tuesday, health minister Aaron Motsoaledi said the construction of new public health facilities that Ramaphosa listed in his address was part of the gradual rollout of NHI.
Ramaphosa said that Limpopo Central Hospital and the Siloam District Hospital in Limpopo, the Dihlabeng Regional Hospital in Free State, the Bambisana District Hospital and Zithulele District Hospital in Eastern Cape, and the Bophelong Psychiatric Hospital in North West were either under construction or undergoing revitalisation.
“It is going to be a very interesting and well-thought of list in support for the NHI. Hence the site of such hospitals is going to be very strategic for NHI to thrive,” Motsoaledi said on Tuesday.
“Due to the nonavailability of time, today I will desist from providing a list of all the new hospitals that were mentioned in the Sona. I will provide such a comprehensive list during my budget vote in about three months’ time.”
The NHI aims to ensure universal free services at the point of delivery, regardless of socioeconomic status. It aims to scrap the current health system, which gives those who can afford medical scheme cover access to costly, but generally high-quality, services in the private sector. The majority of the population, meanwhile, depends on largely free but uneven services provided by public hospitals and clinics.
One of the most contested aspects of the act is its limitations on the future role of medical schemes.
Ramaphosa will set up a ministerial advisory committee, expected to comprise government officials, cabinet ministers and private medical aid scheme representatives, to resolve the impasse.
“There is another storm brewed by big business, the media and all other critics of the NHI, that implementing the single payer system as the NHI Act asserts is unconstitutional, will collapse the economy and deprive people of a right to choice,” Motsoaledi said.
“They say a multi-payer system is the only reasonable system. They believe, wrongly so, that we are the first country to be confronted with a choice between a single payer system and a multi-payer system.
“NHI is about money that is failing and equitably distributed among the whole population. It is about what each and every citizen gets from their country for their healthcare needs and not because of their income and/or socioeconomic status.”
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