News that President Cyril Ramaphosa will sign the controversial National Health Insurance (NHI) Bill into law on Wednesday has been met with dismay by organised business and healthcare professionals.
Business Unity SA (Busa) said it was deeply concerned by the development, as it believed the legislation was unimplementable and would damage the health system, the economy and investor confidence.
Ramaphosa has puzzled observers by the delay in signing the bill, which was submitted to him in December. In his state of the nation address (Sona) in early February, he quipped that he was “looking for a pen”, but said nothing further until announcing on Monday night that he had finally assented to the legislation.
Busa has lobbied hard against the bill, saying that while it supports the need for reform, the legislation is unworkable, unaffordable and at odds with the constitution. It has previously expressed dismay that the submissions it made during the bill’s passage through parliament were ignored, and petitioned the president directly after it was passed by the legislature in December.
Busa CEO Cas Coovadia said the organisation would consider its options after the President’s announcement on Wednesday.
“Our subsequent actions will be guided by our belief that it is essential that we get the NHI right through all means still at our disposal, including appropriate legal interventions, so that the legislation that is finally implemented is in the best interest of our country, and all her people, for generations to come,” he said.
The NHI Bill sets in motion the ANC government’s plan for implementing universal health coverage, which aims to create a single health system in which patients receive care that is free at the point of delivery. The bill is the first piece of enabling legislation for the plan, and paves the way for the creation of a government-controlled NHI Fund, which will be the sole purchaser of services provided under the scheme.
Where we are now is unprecedented, and we believe that the NHI, in its current form will reverse, rather than progress, equitable, quality healthcare in SA.
— SAHPC spokesperson Simon Strahan
The government has yet to specify how it will be financed, but the ANC has consistently said it intends to redirect the money employers and individuals pay to medical schemes into the NHI Fund by taxation, a proposition critics say is unviable.
The SA Health Professionals Collaboration (SAHPC), a group of nine medical, dental and allied healthcare professional organisations representing more than 25,000 individuals, said it was profoundly disappointed that the bill was to be signed into law.
The SAHPC wrote to the president in December, urging him to refer the bill back to parliament on the grounds that it was unconstitutional and not in the best interests of patients. Its input on the bill had been ignored, it said.
“Our members have made submissions at every stage of the legislative process, dating back to the release of the green paper in 2011. It is disheartening to see our efforts to contribute to a more robust, workable and patient-centric healthcare system being ignored,” SAHPC spokesperson Simon Strahan said.
“Where we are now is unprecedented, and we believe that the NHI, in its current form will reverse, rather than progress, equitable, quality healthcare in SA. We have no doubt that the NHI Bill will be challenged in the courts, and we are currently exploring all our options in this regard,” he said.
The DA said the president’s decision to sign the bill was a cheap election ploy, and the party would challenge it all the way to the Constitutional Court.
“We have built up reams of correspondence, including with Ramaphosa himself, that we will enter into evidence to show that the process that led to the adoption of this bill by Parliament disregarded public input, and that the bill itself is flagrantly unconstitutional,” said DA leader John Steenhuisen.
The DA would immediately repeal the bill if it was voted into power on May 29, he said.
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