Opposition parties have criticised President Cyril Ramaphosa’s signing of the National Health Insurance (NHI) Bill into law at the Union Buildings on Wednesday as an election gimmick before the May 29 elections.
Pollsters have indicated that the ANC, which is bleeding support, will struggle to get the 50% plus one it needs to govern.
Opposition parties said the passing of the bill was a deliberate ploy — magnified by the pomp and fanfare that accompanied it — to arrest the ANC’s misfortune.
Freedom Front Plus (FF+) leader Pieter Groenewald said Ramaphosa’s decision to sign the bill into law two weeks before the general elections “demonstrates just how desperate the ANC is”.
“Government is willing to sacrifice the country’s entire healthcare system to remain in power for another term,” said Groenewald. “The FF+ will join forces with all interest groups that are prepared to fight the NHI all the way to the Constitutional Court.”
He said the NHI was an unrealistic dream used by the ANC to create the illusion of world-class healthcare for everyone in SA. “It is not viable.”
The DA said the bill did not pass constitutional muster. “More critically, it will not solve the widespread public health crisis in SA. The signing of this bill, despite resounding opposition to it, is nothing but an electioneering tool by the uncaring ANC.”
Trade union Solidarity described the legislation as “irrational and unaffordable”. It too said it would go to court. “The NHI will cause unprecedented damage to taxpayers, not to mention the economy,” said its deputy CEO of legal matters, Anton van der Bijl.
Funding model
Reuben Maleka, GM of the Public Servants Association (PSA), which represents more than 245,000 of the 1.3-million public servants in the country, said the NHI in its current form will present “more challenges than solutions”.
“The PSA previously requested the president to delay signing the NHI Bill until there is clarity regarding the funding model,” Maleka said adding that the funding model presented by the department of health lacked sustainability. “It disproportionately burdens the working class, who are already struggling to make ends meet,” he said.
“Government’s plan to increase VAT and income tax to offset the NHI deficit raises serious concern.”
However, the presidency denied the signing of the bill was for political expediency.
Spokesperson Vincent Magwenya said there would have been no logic in Ramaphosa delaying the signing of the NHI Bill until after the elections.
“The fact that you have an election is purely coincidental,” he said.
“What was important was for the president to thoroughly satisfy himself that the process leading to the passing of the bill was conducted in a manner that is in line with the applicable statutory provisions, look at the submissions that were made and how those submissions were responded too,” Magwenya said.
He added that delaying the signing of the bill because there might be a legal challenge also made no sense.
The National Education, Health and Allied Workers’ Union (Nehawu), an affiliate of the ANC ally Cosatu, commended Ramaphosa for signing the bill into law, describing the move as a watershed moment.
“It signifies a progressive step towards government fulfilling the constitutional obligation, more particularly section 27, subsection 1, which enjoins government to ensure that everyone has access to healthcare,” said Nehawu general secretary Zola Saphetha.
Private system
Saphetha said the bill was a result of 20 years of dedicated struggle as it went through “extensive scrutiny and debate” at the National Economic Development and Labour Council, the portfolio committee on health, and two presidential health summits, and through public participation processes in all nine provinces through the National Assembly and National Council of Provinces.
“More than half of the country’s health spending takes place in the private healthcare system, which only services 16% of the population, and only 9% of the African population are members of medical aid schemes,” he said.
The Democratic Nursing Organisation of SA (Denosa), also a Cosatu affiliate, said the signing of the bill into law marked a move away from the undesirable legacy of two unequal healthcare systems in one country.
Political party Rise Mzansi said though it supported universal healthcare, it did not support the NHI because its funding model, the structure of the fund and implementation plan are “flawed” and it is likely to cause the collapse of the health system.
“SA needs the eventual convergence of the public healthcare sector, which is marked by high patient volume, underfunding, corruption and in some instances poor skills, with private healthcare,” said Rise Mzansi’s Irfaan Mangera.
This view is supported by the ACDP, which voted against the adoption of the legislation in parliament. “None of the concerns of the health sector have been given due consideration, with public participation merely becoming a tick-box exercise for this government,” the party said.
ActionSA said that in its current form the NHI would open up the health sector to state capture.
Cosatu acting national spokesperson Matthew Parks said: “Society cannot afford to normalise 30 years into democracy the reality that most South Africans, in particular the working class, lack access to quality and affordable healthcare.”
— With Thando Maeko
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