President Cyril Ramaphosa has fulfilled his commitment to enact the National Health Insurance (NHI) Bill before the 2024 national election, officially bringing the contentious healthcare system into effect in South Africa.

The president signed the NHI Bill into law during a ceremony on Wednesday, 15 May.

In his address preceding the signing, Ramaphosa defended the bill against its critics, emphasizing that opposing the NHI is contrary to the global trend toward universal healthcare. He highlighted that the NHI aims to unify South Africa’s divided healthcare system, addressing the disparity where the private sector serves a small segment of the population while the public sector remains overburdened and underfunded.

Despite the bill’s signing, it has encountered significant opposition from various stakeholders, including the healthcare sector, business groups, unions, workers, and legal experts. While there is broad support for the goal of universal healthcare, critics have serious concerns about the NHI’s approach, particularly its plan to eliminate private funding.

Concerns have also been raised about the uncertainties surrounding funding, coverage, and implementation, along with fears of corruption, mismanagement, and maladministration—issues often associated with state-run entities. The NHI Fund, which will oversee the system, is now a focal point for these concerns.

Several legal challenges have been in waiting for weeks, anticipating the president’s decision. These challenges are now expected to proceed through the courts, with some aspects of the NHI laws likely to reach the Constitutional Court.

Healthcare analysts and medical aids have indicated that immediate changes to the healthcare sector are unlikely, even with the laws now in effect. The implementation of the NHI system will be gradual, with Discovery CEO Adrian Gore describing it as a “multi-decade” process.

In his remarks, Health Minister Joe Phaahla stated that the NHI rollout would not be an overnight event. The process will unfold over time, adhering to proper procedures, including regulations, implementation protocols, and public consultations. He noted that preparations have already begun, with the establishment of the NHI Fund expected within the next six to twelve months.

Source: Businesstech