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NATIONAL HEALTH INSURANCE

In a surprise move, Ramaphosa to sign NHI Bill into law before 29 May elections

In a surprise move, Ramaphosa to sign NHI Bill into law before 29 May elections
President Cyril Ramaphosa. (Photo: Shelley Christians) | The National Health Insurance completely overhauls health and will mean all South Africans will have to sign up to the NHI to allow a pooling of private and public spending on health. (Image: Darko Stojanovic / Pixabay)

President Cyril Ramaphosa says healthcare ‘apartheid’ must end, but opposition parties and the private medical industry are likely to go straight to court over the NHI Bill.

Fourteen days before the elections, President Cyril Ramaphosa will sign the country’s biggest health policy overhaul into law, effectively consigning medical schemes to providing options only for small private elective procedures once implemented. 

In a surprise move, Ramaphosa announced that he will sign the National Health Insurance (NHI) Bill into law on Wednesday, 15 May, at 2pm. It is likely to immediately be taken to court by opposition parties and the organised private health industry. 

“[It] directs the transformation of South Africa’s healthcare system to achieve universal coverage for health services and, through this, overcomes critical socioeconomic imbalances and inequities of the past,” the Presidency said.

Health Minister Joe Phaahla will hold a Q&A on the same day to answer critical questions about funding (the Bill can’t be passed without a money bill passed by Treasury) and timeframes for implementation. This is unlikely to be a quick process and may take years.

The Bill completely overhauls health and will mean all South Africans will have to sign up to the NHI to allow a pooling of private and public spending on health. It effectively makes private medical insurance moot. This article sets out how the changes will affect you.   

It’s a disaster done only for electioneering.

In April, Ramaphosa said he would sign the Bill into law to end “healthcare apartheid”, Bloomberg reported. Gauteng premier Panyaza Lesufi also made the NHI a crucial part of his plan to win the provincial election when he told provincial supporters that they could attend any hospital after the elections. Rebecca Davis fact-checked that promise here

In South Africa, poor South Africans suffer long queues, long waits for services and a poor standard of healthcare in the public system, while those citizens (16%) with access to private medical care have access to the country’s world-class healthcare at a very high cost.

A business leader who did not want to be quoted said they were not informed about the coming decision. “It’s a disaster done only for electioneering,” he said. The private sector had raised valid concerns about the NHI but he added that he was not surprised by the decision. He said he thought the President’s strategy of signing so close to the elections was so that he could claim the kudos in the final legs of the most tightly contested election for the ANC yet, but that he knew it would be tied up in court for years. 

A health market inquiry by the Competition Commission in 2019 found excessive prices and practices across the private health industry value chain. The country’s biggest private medical scheme, Discovery, said late in 2023 that its modelling of the latest version of the NHI Bill showed funding of R200-billion would be needed to implement the law. This would need to be financed either by a VAT increase from 15% to 21.5% or by personal income tax increases of 31% across the board for employed people. 

Collecting R200-billion as a payroll tax would require around R1,072 per employee per month. This increases to around R1,565 per employee per month for only those employed in the formal sector,” said Discovery.

The NHI Bill decision shows again that Ramaphosa’s style and power are waning in influence over the governing party.

In November 2023, Cas Coovadia, CEO of Business Unity SA, said the “self-evident truth” was that there was no money for the NHI Bill. There was no clarity on benefits, contracting terms, capacity, systems, management, governance, or even a plan that began to outline these big questions around a national health system.

“We have also repeatedly cautioned against a single fund for the NHI that, inter alia, will require taxes to be raised to unsustainable levels. This is unaffordable, unsustainable and presents a material economic risk.”   

Explainer: The politics of the NHI announcement 

The NHI announcement by Ramaphosa shows that he is a president feeling the heat of a campaign that is difficult for the ANC. It is not his style to take any community, especially his supportive business community, by surprise, since he operates by consensus-seeking. This is how he effectively led the process to adopt the Constitution in 1996. The decision on the NHI shows a very different Ramaphosa. 

Within the ANC, he is under pressure. The first time this was clear was when the ANC Veterans’ League, the proxy body for Ramaphosa’s renewal faction of the party, could not secure the exclusion of confident party leaders implicated in serious graft from the party’s candidate lists for election.

The NHI Bill decision shows again that Ramaphosa’s style and power are waning in influence over the governing party. Even though he is the face and leader of the party’s campaign, Ramaphosa will likely not see out a term if re-elected in the 29 May polls. This is because the party’s next elective conference in 2027 will choose a new president, and in its practice, the party does not allow two centres of power.

It would want to swear in its new president if it is still the governing party. The NHI decision also shows that a grand coalition with the DA, should the party not reach 50% in the election, is an increasingly unlikely option and that a coalition of parties to the left, like the EFF, is a more likely bet. DM

 

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Comments - Please in order to comment.

  • Richard Bryant says:

    Aaah. He moves! Our president is indeed alive.

    It’s been a year since his chosen premier of the Eastern Cape Oscar Mabuyane was exposed as having a fake degree certificate. A year! Yet no action from his boss.

    Imagine that! One of your closest colleagues holding high office is accused of such a fraud and you do nothing.

    But suddenly you find energy and hold a press conference nogal to push through a law about which we all know there is absolutely no money. But there’s an election coming up and you’re desperate for some votes especially those where your dear friend Oscar has power.

    This Ramaphosa is as bad as the alcoholic John Voster. No backbone. No integrity. Time to go.

    • Sphamandla Lushaba says:

      It’s not like Oscar did anything new,

      why would the ANC punish their own when they do what the ANC does best😂

  • Graeme de Villiers says:

    Popcorn makers, be ready…

  • Ken Borland says:

    Apart from the awful news that this article brings, I find it very disappointing that the link in it on how NHI will affect the individual is to that awful, cringeworthy, thoroughly un-credible article by Olive Sishana, the advisor to Ramaphosa. DM need to do better on this.

    • Karl Sittlinger says:

      Hear Hear. Why DM links a NHI article by an obvious ANC shill that ignores any and all counter arguments is beyond me.

      • Rainer Thiel says:

        I put Sishana’s “article” through a few free ai detectors… the assessment outputs vary, here’s what they say:
        quillbot – 45% of text is likely AI generated
        scribbr – 55% chance that your text is generated by AI
        ai-detector – There is MEDIUM RISK that your text was written by AI
        writehuman – 99.79% probability this is human text

        • Cedric de Beer says:

          So you “detectors”range from 45% to 99.79%. What confidence should we put in your “analysis?” Just because it calls itself intelligent, doesn’t mean that it is.

    • JOHANN SCHOLTZ says:

      could not agree more. Instead of the promised “how it impacts you” I found an ideological rant about NHI. I would venture that DM journos and the good Dr will be among the first out of the country when healthcare collapses

    • Bob Dubery says:

      They’ve quoted Discovery on the anticipated funding and how that will be raised with taxation being the only means. Believe me, that will affect individuals. So they’ve covered that.

  • John Lewis says:

    Even though it go through endure years of legal challenges, the Act will put a swift end to all investment in healthcare as well as accelerate the flight of capital and skills. Well done, Cyril and the ANC, for adding year another nail in the coffin. Die the beloved country.

  • Philemon Solomon says:

    Ah yes apartheid! Just in case you all forgot why you need to vote for the anc again…

  • Greg Stewart says:

    While nothing other than a pre-election ploy, it leaves opposition parties in a very difficult position. If they take the matter to court, it becomes a classic election cudgel for the ANC to take to them and declare they are the only party that cares for healthcare for all. If they don’t it becomes a play for the ANC to say they are doing something amazing for all and if people don’t vote for them it will fail.
    This ANC government is as corrupt as you get but they are playing the pre-election game better than other parties and that is the biggest concern.
    Every other party is off launching manifestos or self-imploding or dealing with minor issues or fighting among themselves while the ANC are going into overdrive.

    • Ann Bown says:

      Spot on! Opposition parties and big business will be the bad guys if they take this matter immediately to court.

    • Antonio Tonin says:

      I don’t think that this will be such an issue – rational opposition parties can wait a couple of weeks (i.e. until after elections) before throwing their weight behind the massive legal challenges that will commence immediately. In the meantime, let’s hope that a hawk eye is being kept on the ANC top brass as they seek medical treatment in coming days, weeks and months. Including chartered planes to Moscow!

    • Grenville Wilson says:

      Ja, agreed and the DA are the biggest disappointment of all, I believe that they have let the biggest opportunity they have ever had go begging due to the leadership being arrogant and tone deaf!

  • John Smythe says:

    The “world class healthcare” you refer to Ferial Haffajee is becoming less and less available to the 16% every month as doctors flee the country. Getting an appointment with a specialist is now often several month’s wait and getting longer all the time. I have to book 6 months in advance to visit specialist for my condition. To give some perspective: In 2017, a friend in the UK had to wait for 9 months to have a back operation. He could barely get up from a chair and slept downstairs in his lounge for months before the operation. Now, how on earth is this going to work in SA, Mr President. This with your fast dwindling pool of health professionals coupled with the enduring ineptitude of your cadres and inevitable corruption deluxe. This is going to be a slamdunk for the corrupt.

    • Wilhelm van Rooyen says:

      True – I too was recently told that I could only get an appointment with a specialist in 6 months. Also recently met some SA doctors working in Canada – the Canadian government apparently is trying to recruit some 400 foreign doctors at present – many of whom would come from SA…

      • Kev The Famous Explorer says:

        Both Australia and New Zealand are actively seeking staff in ALL medical professions , from nurses to surgeons , and they are recruiting literally thousands to meet a massive shortfall of medical staff in those countries , and South Africans are more than welcome due to the common language and excellent training they have

    • Mokhele Mokhele says:

      Time and time again, Cuban soldiers stood shoulder to shoulder with us on the battlefield, displaying unwavering loyalty and unwavering courage. And when “our” unpatriotic doctors turn their backs on us, it will be the compassionate hands of Cuban doctors that reach out to heal our wounds, embodying the true essence of collaboration. Together, we have forged an unbreakable bond born from shared struggles and triumphs—a testament to the indomitable spirit that unites our nations as one resilient family.

  • Middle aged Mike says:

    “Fourteen days before the elections, President Cyril Ramaphosa will sign the country’s biggest health policy overhaul into law”

    Enough said.

  • jcdville stormers says:

    All National Corruption Party moves to more plundering of tax payers money

  • Thinker and Doer says:

    It is certainly not a surprise at all that the NHI Bill will be signed into law tomorrow, this is a major plank in the ANC’s populist election platform. It is why the Bill was rammed through Parliament before the elections. The President has been very clear that the Bill was going to be signed into law. The only hope now is for legal challenges to the legislation to succeed.

  • Thinker and Doer says:

    It is certainly not a surprise at all that the NHI Bill will be signed into law tomorrow, this is a major plank in the ANC’s populist election platform. It is why the Bill was rammed through Parliament before the elections. The President has been very clear that the Bill was going to be signed into law. The only hope now is for legal challenges to the legislation to succeed.

  • Geoff Krige says:

    “In South Africa, poor South Africans suffer long queues, long waits for services and a poor standard of healthcare in the public system”. Now with NHI all South Africans will suffer long queues and a poor standard of healthcare. Who, after all, has managed the public health care system for the past 30 years? Except it won’t be all South Africans. The ANC leadership will still enjoy preferential health treatment in Russia, Singapore, Hong Kong, all at tax payer’s expense.

  • Cachunk Cachunk says:

    The useless anc and their spineless flop of a president really couldn’t care less about our futures. It is so obvious that this is a complete disaster in the making.

  • rewardnetza says:

    Why do you see this as a “surprise” move?
    We were all expecting this “strategic” move before the elections!

  • Rob Currie says:

    Will “universal coverage” mean I can use it anywhere in the world … or even universe?

    • drew barrimore says:

      Recalls the joke: “Why is Ms Universe ALWAYS from Earth??”

    • drew barrimore says:

      We all know that State hospitals are a death-trap filled with the semi-skilled, the unskilled and the highly unionized, barring one or two Western Cape exceptions (Tygerberg/Groote Schuur). We all know the standards of nursing have slipped to often dire levels – but hey, they all get something called “a degree”, which is far more befitting ‘our people’ than going to the old nursing colleges, now shut down. We all know how dismally the pilot roll-outs of this so-called NHI performed, all a failure with lo-and-behold, corruption! We all know this is an election ploy trump-card (see how we care, vote for us). And we all know Dr Nicholas ‘Peppermint’ Crisp is the health attack-dog for the ANC, an individual who comes across as dying to be in the company of Kim Jong Un, Putin or Xi – so watch out for what he says. After this ANC President has ‘found his pen’ (so cute, so confident that phrase, so diluting of the seriousness of this looming mess) – we can all expect at least twenty years of litigation, or at least eleventy years as is the case with the other ANC hero, Zuma.

  • Shaun Pastor says:

    Ok, so let me take a trip down memory lane quick. Mandela’s words when he was let out after a long time was, You will give us control of the government or we will burn this country to the ground. (My words, not his exact words.) So, the cANCer is the most successful political party we have ever seen. Burn the country to the ground…. hmmm. First off they got rid of NOSA. A superior safety method of doing anything on the job, with star ratings for companies. Today we see the consequence of that, George building collapse. Then they got rid of apprenticeships and trade test centers. I did the 5 year on the job training, apparently you can do it now over the internet from home in 1.5 years. Look at the Eskom saga with journeymen. The railways, The airports, The schools, yea kids shooting each other on the playground instead of, I’ll see you behind the shooting range after school, gotit. The quality of the roads, walking to KFC after 6 pm, hehe hope you make it home with the chicken. My dad was a reservist for a while, helping with odds an ends. The police force every country has to comfort the population as to there safety. Here we dare not get into there line of sight, you might get the wrong end of the stick. It’s not even safe to pull over when hailed to do so with the lights and everything, as any driver would respecting the law and all that, now you have to drive to the nearest cop shop or garage if you value your families lives and your own. We used to hitch to Durban to go partying for the night. Now, public transport is a mess. viva tax’i. Did I miss anything? Oh right, the hospitals, now because he cannot maintain his public hospitals with the couch money 😉 now he tries the NHI bill and we must pay for his dumb plans. Ouch, yea. I see a world of hurt if they are to remain in that comfy office where the lights NEVER go off, or the aircon. Just a thought. Lets see if this comment makes it past DM’s admin pc. 😉 The truth will come out somehow, it always does.

  • Dragon Slayer says:

    If ever there was an acknowledgement of ANC’s expected loss of power this utterly irresponsible act of desperation is it. On one hand, it is a desperate move to get votes based on yet another promise it cannot keep . On the other, scorching the earth for any coalition that will succeed the ANC. It certainly seems the ANC has no qualms about burning South Africa to the ground so that it can say “we told you so”.

  • Daniel van Dalen says:

    We already have universal healthcare. The majority of public hospitals are just totally mismanaged. NHI just another way to access a large pot of money. RAF, UIF, WCA, SOE’s. How is this going to go any other way. Pity the private hospitals who are going to have to wait for their money from the NHI. If IOD and WCA cases are an indicator, they will all bankrupt within a year.

    • Kenneth FAKUDE says:

      Daniel the one thing that major opposition parties and people who read past NHI fail to understand is the average voter’s mind.
      The president’s statement is music to their ears and the picture is bright of finally being treated in a private hospital bravo!
      It’s an awful waste of time to go to the courts, opposition parties must up their campaigning game, get the votes and steer the country in the right direction.

  • Jimbo Smith says:

    Another day; another ANC gifted disaster! Two realities; firstly, first world countries have shambolic NHI like systems which have been in place for years (e.g. UK) and secondly, our rare breed of “geniouses ” can’t even manage a basic health care system which is broken. But hey…we’re in a corner so we’ll just ram through NHI. Hopefully, this will be wrapped up in the courts for years, at huge taxpayer expense AGAIN!!

  • Ed Rybicki says:

    And here it comes…another monolithic state entity that will act as a feeding trough for the ANConnected,while raisingtaxes and/or VAT – the first of which will simply punish that unfortunate minority in this country that actually PAYS tax. Consider this: we the taxpayers ALREADY fund government healthcare, which is probably the best in Africa (outside of Botswana, MAYBE). We also belong to Medical Aid schemes, so we pay double – for the privilege of getting healthcare THAT THE GOVERNMENT DOES NOT HAVE TO PROVIDE FOR US. Now – we will almost certainly have to pay more, to get less, and at far less convenience for us. I sincerely hope this fustercluck gets immediately tangled up in litigation until it withers and dies – because otherwise, the exodus of medical professionals will turn into a raging flood 😢😱

    • Hello There says:

      It will also precipitate emigration in general, because people can make plans for times w/o electricity, even w/o water (to a lesser degree), but no one can be w/o a functioning health care system (no one who aspires to be productive at an internationally comparable level while not dying on the way trying)…

  • M E says:

    Only reason the NHI Bill is being pushed through before elections, is so that in the event the ANC loses it’s majority, they don’t have to worry about figuring out how to develop the NHI. Appealing to the masses again with empty words. Just as Zuma announced NSFAS with no plan. We all know what a mess that is…

  • Mlungisi Mbambisa says:

    What alternatives do we have? Is this NHI different from the British one or Obama care?

    • Geoff Coles says:

      Very

    • Karl Sittlinger says:

      Yes it is. Many reasons, from tiny tax paying pool (income tax) to dysfunctional hospitals ravaged by corruption, all the way to the anomaly that no private medical aid will be allowed for procedures covered by NHI (in almost all countries there is the freedom to get private medical aid in addition to the public one).
      Add this to the fact that every institution (with exception of SARS, surprise surprise) that the ANC has touched has become corrupt.
      The NSFAS is the perfect example, but here we are talking about much higher numbers.

      • Dragon Slayer says:

        No it is not different – in theory – only in its ability to be implemented. UK and US have a tax base of 80% payers and 20% grants – RSA has the opposite. UK and US have a competent civil service that does the basics efficiently, serves everyone, and only tweaks to accommodate democratically induced political ideology – not a government that serves itself at the expense of the people.

        • Karl Sittlinger says:

          “No it is not different”

          I disagree! The option to have private medical aid on top of a national health insurance is very different than having mandatory national health insurance only.
          As things stand now, I will soon have no viable choice or options when it comes to my health care. In the UK, Germany etc you can still have private medical aid either in addition or as in Germany for instance completely private as an alternative.

    • Marina Hall says:

      Very different systems and not the same as the one proposed here.

      UK – can still have private insurance that runs alongside NHS and allows members to choose who treats them and when.

      Our NHI won’t allow medical aids to treat ANY conditions covered by NHI.

      US ACA – Obamacare was introduced to allow people access to affordable medical insurance even if they have preexisting conditions ( members pay for this). Medicaid could apply for those earning below federal poverty levels.

      While UK is plagued with staff shortages and backlogs their actual facilities don’t face the challenges ours face. Recently about 400,000 people were given the option to take treatments nationally rather than at facility closest to alleviate backlogs.

      2018/19 NHI spend for England alone was £129billion (R3,2 trillion at current exchange rate)
      UK Population 67million & employed is 33million.
      SA population 60million & 16,7 million employed

      Can we truly afford this now?

      Perhaps we need to first focus on fixing our failing public health facilities and systems…

    • Steve Davidson says:

      Totally. Both countries have private hospitals just like SA now, plus their public systems are run by reasonably professional people (although the UK, from personal experience, isn’t run as well as it could be, and will hopefully be improved once the useless Tory government is kicked out) unlike what we would no doubt get here, even more of the cadaver deployment and corruption that has ruined everything else. Next question?

  • Sonja Bakker says:

    Ramaphosa needs to explain why sick people are currently waiting months, sometimes years for treatment. The problem that he seems to be forgetting is that the 16% that has proper medical is the people that are paying the taxes that runs this country. If only 1% of these people cannot work due to medical problems, who is going to pay the taxes and what is the effect going to be on our economy. Never mind all the investment that is going to die a sudden death, less jobs, less taxes, less money for the government.

  • Soil Merchant says:

    Separation of party and State, hmm?

  • Kev The Famous Explorer says:

    Well well we can expect the Rand to incur a “Moron Premium ” starting around Thursday or Friday this week . History reminds us of when Robert Mugabe signed an Amendment to Legislation to pay $70,000 to each War veteran ( 60,000 ex combatants) which the Government could not afford, was not budgeted for and simply had no way of paying , the effect on markets was immediate . The Zimdollar collapsed in 72 hours as foreign investors first pulled their money from the Zimbabwe Stock Exchange sending it into a tailspin , and then in the next step they removed their money from the country (The ZimDollar was free floating against the US$ under ESAP at the time there were no exchange controls ) That all happened in a day …….and by what they refer to as Black Friday it was in meltdown ………..By Monday the following week the currency had lost 25% of its value , the Reserve Bank belatedly, massively increased interest rates and imposed exchange controls , but it was too late the damage was done. Zim has never recovered from the stupidity of its spectacular Fiscal indiscipline in making spending commitments it could never afford ………… and yes they actually went ahead printed the money to pay the ex -combatants …….. like WTF ? The harsh reality is markets punish Governments for their reckless profligacy and stupidity , something South Africa has yet to learn

  • Middle aged Mike says:

    The new dawn isn’t panning out quite as well as some of the credulous muppets amongst us imagined.

  • Stephen Brooks says:

    This was about as big a surprise as the sun coming up this morning. Another predictable event is the recommencement of load shedding after the election.
    Would anyone like to predict the reaction of medical aid members to their continuing to make payments if and when NHI is implemented?
    This is going to be the biggest gravy train since state capture.

  • Rob Rhodes-Houghton says:

    “Surprise move” – really?

  • Geoff Coles says:

    How many different ways can you express how disgusting is Ramaphosa

  • Hilary Morris says:

    If ever proof was needed (and it wasn’t) of this man’s duplicity, cynicism and manipulation, here it is. To sign into law a bill that he KNOWS is impossible to implement, is unforgiveable. It also shows very clearly his opinion of the intelligence of his supporters.

  • Colin Louw says:

    I desperately hope that the DA has enough intelligence to wait 17 days before filing a court case fighting this!! This is a time when the IQ behind the DA executive has to rise to triple digits and understand how politics and electorates actually work in SA!! DA DON”T LEAD WITH THE CHIN, don’t get sucked into a stupid gunfight carrying only a stick!

    • Michele Rivarola says:

      Every Medical Aid, Hospital Group and association of medical practitioners will challenge it, so no need for politicians to become involved, the private sector, as usual, will look after its own interests.

      • Kanu Sukha says:

        Just love the last three words …. or is it phrase !!! Sounds familiar in more ways than one though . Probably did not see that coming ?

  • asdf asf says:

    He is a vile petty thief.

    He knows very well this will never get passed in current form. But he knows the ANC voters are not intelligent enough to grasp this. Luckily for him the legal bill from the litany of court hours will be footed by us — the bent-over tax payer.

    Your president is simply, once again, using tax payers money to buy the stupid vote.

    • Mrs Viljoen says:

      Exactly! This will be tied up in court for years but the ANC don’t care,they just want to get through with the elections to see if they will remain in power. Disgusting but expected.

  • Rae Earl says:

    Whatever happens, the DA must NOT rail against this treasonous election ploy until after the election. Let this awful president sell his soul to the devil by finding his pen and doing the most disgraceful thing he has ever done. After the elections the litigation can start, not before Mr. Steenhuisen. Any DA backlash against the NHI now would cost the party dearly in lost votes on 29th May.

  • Jehan Bektir says:

    This is Ramaposa’s “hospital pass” to whoever his successor will be.

  • Andre Swart says:

    The timing is SUSPECT!

    The ANC is trying expropriate private healthcare, without compensation!

    The ANC won’t be the sole governing party in a few days time … this matter must better be left for the new government to decide.

    Get an urgent court order to stop ALL toxic laws being FORCED through!

    Because the ANC is not the ‘de facto’ government any longer!

  • Reasonable Observer says:

    Law does not mean it’s implemented. That will take a while, and many years of court cases to follow, and even without that, government bureaucracy will move at it’s own time. So don’t hold your breath.

    But the uncertainty it creates means that in the meanwhile, private investment is grinding to a halt, which will drive prices up.

    The said article referred to in the sentence “This article sets out how the changes will affect you.” was written by an ideological apologist, and the arguments are of very poor quality, riddled with unsupported claims. I understand the DM’s desire to present different views, it would have been good if that article is not uniquely linked as someone looking for information on how the changes will affect the average reader.

    The UK has a much higher ration of tax payers to the general population, and currently they are really struggling to keep the NHS (was they call it) functioning. Some people wait months to see a specialist, which has lead to many late diagnosis on conditions like cancer that could have been treated. Ironically some South African medical aids are stepping in to fill the gap in the UK, such as Discovery.

    I don’t think even people who vote ANC using the brother-in-jail or reward-for-Mandelas-party really think the ANC can be more efficient. Not one ANC politician or middle class apologist has the police’s number on speed dial, as opposed to private security. The NHI is more complex to run than security backup.

  • Alan Watkins says:

    On wednesday the minister of health is going to answer questions on how this is to funded. That should be interesting.

    • Harry Boyle says:

      Be interesting to see if it will be an open Question Session or will it be Pre approved Questions submitted before hand?

  • Bruce Gatland says:

    The last destructive kick of a dying horse.

  • Dennis de Necker says:

    Just asking for clarity:
    1. My family’s current contributions will go into ‘the pot’ along with that of EVERYONE else in the country
    2. I will be able to go to my chosen hospital or clinic – I will not be re-directed by the state
    3. I will be able to make an appointment for a day and time that suits me, not the facility
    4. The people that used to rush off to Cuba and Russia in order to receive quality medical attention for their colds and undisclosed ailments on luxury private planes (paid for by the SA govt – ie the tax payer), along with the usual entourage of bodyguards, distraught family members and companions – all housed for an extended recovery for one person while staying in a 5-star hotel, will now be in the same queue as me and my family – no special queues?
    no queue jumping or rank-pulling?
    no special treatment and choosing of doctors?
    no private wards?
    Sounds good to me.
    The savings that SA will achieve by banning our regular ‘diplomatic flights’ while also fitting in hospital visits, will go a very long way to build up some nice cash reserves.
    As long as the guns and bodyguards do not add to the length of the queue – I will then even leave my 2x German Shepherds at home while I join the queue for a general checkup, just to witness the terrified expressions of this pampered lot.

  • Titus Khoza says:

    People will still need healthcare beyond the elections.
    So please Mr President sign the bill!

  • Michael Clark says:

    “Rather be a weak president than split the ANC” Cost to country will result in an overwhelmingly disaster for SA, and untold riches to the gangsters at Lootfreely House and their tenderpreneurs!

  • Richard Bryant says:

    The same Olive Shisana headed a commission of enquiry into so-called National Health Insurance in the late 1990’s. They have been trying that long to ram this misnomer through. I say misnomer because by definition, any insurance involves the payment of premiums. Only if you pay premiums, you get cover.

    So in truth, this is a National Health Service such as the UK NHS, except some members will have to pay and others not. They are petrified to call it this because, even the UK cannot afford it. But that is what it is.

    I was personally involved at the time in providing comments to the Shisana commission. We recommended that a compulsory NHI scheme be developed to cover all employed people. It makes total sense for both employer and employee to participate in a scheme to ensure sick people are able to quickly return to work. The State then could concentrate on the indigent and unemployed. The idea was that compulsory NHI would help provide funding to State hospitals and clinics, and that people on the compulsory NHI would get into a fast queue to get treatment.

    This would provide an environment where the State facilities would eventually compete against private hospitals to provide services to medical aid members. In the end, this would help drive the cost of medical aid down.

    Instead, the commission recommended the creation of prescribed minimum benefits for all medical aids. This has been the most devastating measure making medical aids largely unaffordable.

  • JC Coetzee says:

    COVID: ‘and the money will not be stolen’ NHI ‘and the money will be stolen’. And the poor will continue to suffer.

  • It is not fair four our President to sign the NHI Law, he must first think about our health, he is so fortunate because when he is sick he will fly overseas to get good doctors. “Ga re lekane re se meno”

  • Scott Gordon says:

    Hmmm , CR taking notes from his buddy Xi .
    ‘Common prosperity for all ‘
    The CCP took 600 million out of poverty , by lowering the bar .
    No free health care over there .
    Has anyone read all the fine print of this new law ?
    “[It] directs the transformation of South Africa’s healthcare system to achieve universal coverage for health services and, through this, overcomes critical socioeconomic imbalances and inequities of the past,” the Presidency said.”
    short and sweet , any details of how that will be done ?
    Committees and panels will be formed 🙂 More cadre deployment .
    As for the cash to fund it ?
    A payroll tax is the only way at Vat is a no no .
    So , all those on a payroll will be paying between R1100/R1600 / month .
    And all get free treatment with those that do not pay .
    As a single guy , that would save me over R3000/month on medical aid 🙂
    The $$$ have been around . Just that the anc , stole , lost it !
    East Cape health dept has more claims against than their total budget .
    Where have all the many billions gone from poorly performing munis and local govt ?
    CR is grasping at a very thin straw , after hinting that only the anc would keep grants going after the election .
    this is just CR and his millions of jobs , smart cities , HSR .
    how will ‘ they ‘ take control of all the private hospitals , some shareholders might be asking .
    Frankly , all talk .
    which is about all the anc does .

  • Miss Jellybean says:

    NHI brought to you by that “genius” currently messing up Home Affairs – Aaron

  • Mike Newton says:

    Electioneering. I foresee years of legal action.

  • Philemon Solomon says:

    Ramaphosa proving himself just as evil as the rest off them. Hold on to power at all costs. Destroy this beautiful country without caring…

  • Jabu Mhlanga says:

    The signing of the country’s biggest health policy overhaul into law is quiet telling. Pretty clear as mud.

  • R S says:

    Free housing. Free electricity. Free education. Free land. And now free healthcare.

    The ANC will continue to grab whatever it can to claim votes. Let’s just hope voters aren’t stupid enough to fall for it.

    • The real Ellon Must says:

      Don’t forget free salaries! One employee in the Public Works and Infrastructure department with a salary of R3.9 million has been on suspension for since 2020!

  • Coen Gous says:

    Ferial, I value your articles above anyone else in SA, including your editor who seems dead quiet. Regarding this bill….laws can change overnight, and I d n9t agree wth this one. But s9mehow there needs to be protection for those, who do even have the means to go to a public hospital, never mind a private facility, the exclusive right of for the well-off, and you should know who I mean

  • Freezaburn    says:

    The Court recognises, essentially, that the right to human dignity contained in section 10 of the Constitution protects “the freedom that everyone has to make their own decisions” — freedom of choice.
    How then, in our democracy, is that freedom of choice taken away from people when the ultimate implementation of the NHI will remove private healthcare as an option and force NHI down everyone’s throats? I am not saying that there is no need for basic universal healthcare but until there is a clear plan on how this will be funded, NHI only looks good on paper. Once our freedoms are slowly but surely eroded, the rest of them will follow suite in due course.

  • Brent Wilkinson says:

    NHI will be implemented just like the anc stopped loadshedding.
    This is just a show for elections, but unfortunately the intellectuals voting for the anc will believe the empty promises just like before.
    The anc believes that we are all idiots to believe them, because the voters are telling them so. The anc was never the problem, it is the highly educated anc voters that is the problem.

  • Michael Thomlinson says:

    So I wonder where Cyril and the comrades will go when they are sick? Pretty inconvenient to have to go to Russia just for a sniffle but I am pretty sure they are not going to go to the local government hospital. I think we will see an exclusive hospital network set up just for them? This is sick electioneering at its best.

  • Bjorn B says:

    As a young, educated South African, I’ve sought reasons to fight for and stay in this country. Yet, the ANC has made it increasingly difficult to remain optimistic month after month. It’s become apparent that they have no intention of helping our beautiful country and its people reach their potential and blossom into the spectacular rainbow nation that the world once spoke of.

    My heart breaks for South Africa every day, and like many others, it seems I’ll be forced to start my family elsewhere — what a shame. Is there any reason to hold onto hope?

  • Graham Swan says:

    Not surprising just before elections – was to be expected. The masses will all praise the ANC…it’s a disaster waiting to happen….THE ONLY THING 100% GUARANTEED IS IT IS ANOTHER BIG PIGGY BANK BEING SET UP FOR THEM TO LOOT, STEAL, AND DESTROY…..all they good for……

  • Lucifer's Consiglieri says:

    What this shabby electioneering ploy will mean in time is that from access to quality healthcare being limited to those fortunate enought to be employed in the formal sector, it will become limited to only the very wealthy (and, of course, the top politicians) – those able to afford to travel for their medical care to the same countries to which all South africa’s top class medical professionsals will have emigrated.

  • Kevin Schaafsma says:

    The biggest immediate problem that will arise is going to be the dramatic flow of medical specialists out of South Africa. And once they’ve left there’s no replacing them. They are not going to wait for this to play out in the courts etc. Cardiologists, gynaecologists, ophthalmologists, surgeons, anaesthesiologists, plastics, orthopaedics, nephrologists and many more are simply going to leave. There will not be this world class rainbow healthcare system catering to everyone in South Africa that we currently see in the private healthcare sector. That needs to be built from the ground up. There will simply be a clinic system of primary healthcare with no specialist follow up care available, and with all hospitals quickly falling into disrepair as corruption takes hold and the healthcare coffers are looted. And then the real brain drain of all those who can will abandon South Africa. I don’t believe that Mr Ramaphosa doesn’t know this and I’m actually surprised that he is involved in doing this. History will not be kind to Mr Ramaphosa and the ANC over this decision which will effectively and permanently reduce South Africa to failed State status. Oh, what could have been but for the power hungry and corrupt ANC!!

  • Bob Fraser says:

    Bob F May 14th 2024 at 16:29
    Mr. President, you have really let the intelligent section of the South African public down. You have very obviously taken the decision to sign the the Bill so close to election date as you believe this will ensure that
    ANC remains in power. It remains to be seen as all the opinions which I have read predict that ANC has no chance at all of a two thirds majority and your only hope will be to form a coalition.
    This may be a part solution to the dreadful mess you and the ANC have lead South Africa into. But I seriously doubt it.

  • Bob Fraser says:

    Mr. President you’re really kidding yourself if you believe signing this bill so close to election date will ensure a two thirds majority for the ANC. We, the electorate are not as thick as you think we are. All polls which I have seen predict a possible coalition which may well be the answer to the political mess created first by Zuma and then
    Ramaphosa. This may work provided EFF are left out of the equation.

  • David Barraclough says:

    And if all else fails, we’ll sign the unworkable, unimplementable, unprocedural, financially impossible and unconstitutional NHI Bill two weeks out from the election in order to try to win a few more votes. This, without changing the Bill at all after thousands of stakeholders from across the spectrum (left and right) of business, medicine, healthcare, civil society, and politics objected to it. This verging on juvenile and irresponsible electioneering ploy suggests that Ramaphosa is just as bad as Zuma – but just in a different kind of way. He should have put South Africa first by referring the NHI Bill to the Constitutional Court first for assessment. Instead, it probably became one of the first Bills in South African history to be used entirely for electioneering purposes. This is shameful.

  • A Voice says:

    “‘[It] directs the transformation of South Africa’s healthcare system to achieve universal coverage for health services and, through this, overcomes critical socioeconomic imbalances and inequities of the past,’ the Presidency said.”
    No Mr President, it will not.
    The ANC was given the means to do so when you were handed a gem of a country, a gem sir, on a silver platter. All you needed to do was to skillfully expand and develop an already impressive and functioning infrastructure to make sure you accommodated those who a racial and nationalistic government had neglected.
    But this does not seem to be the case, does it? That the ANC has to now say that this NHI will be a solution to overcome inequalities, really? A slap in the face to all, all citizens of our Beloved country.
    Apparently, the racist and national ideology that drove the past, drives the present. The difference was that the previous enough foresight to keep our country functioning.
    Have you, the previous presidents, and the ANC kept our country functioning sir? Will this NHI get the country a step closer towards functioning?
    In a speech given by Oliver Tambo on the 22nd July 1985. A speech given to mobilize those who were oppressed, to strive, struggle and battle to shatter the oppression. As he called people to action, the agenda was to cripple South Africa, he is recorded as saying that the desire was to, “make all of our country ungovernable.”
    Are we to understand then, that the ANC has succeeded?

  • Grenville Wilson says:

    Agreed, I am afraid that DM has completely lost the plot as far as well researched, and balanced reporting goes. I have been supporting DM with a monthly stipend in support of freedom of the press etc etc!! But I have enough of the Drivel that DM publishes from certain journalists, clicking on the said link might just be the straw that breaks the camel’s back. Drivel, Drivel, Drivel!!

  • James P says:

    Apartheid healthcare ended long time again, it was good. The crap we have now is ANC healthcare, not existent, corrupt, dysfunctional, another proper ANC botch-job. These thieves have literally not done anything right, they have sucked the blood out of the country like ticks.

  • Grenville Wilson says:

    No Surprises here!!! Another rubbish headline from DM!

  • D'Esprit Dan says:

    Methinks the ANC polling is showing they’re taking a bath (lucky they’ve got water), so they’ve decided to drown the whole country in their evil lunacy.

  • D'Esprit Dan says:

    Methinks the ANC polling is showing they’re taking a bath (lucky they’ve got water), so they’ve decided to drown the whole country in their evil lunacy.

  • Malusi Ndungane says:

    The good news is that eventually this bill will eliminate double standards within South African health care: currently most get a poor service but some get a good one; eventually everyone will get a poor service. Marvellous!

  • Bob Dubery says:

    Does this make any difference?

    OK… Cyril doesn’t sign this now. Let’s say a new President comes into power after the elections. That person will still have to grant the bill assent – it was passed by Parliament, so unless there are constitutional issues with it, it must be signed into effect.

    OK… one difference. It’s done now, Cyril is sending a message “see, we care about your health.” Contrast this to the DA who are going to allow you to work for nothing, or to the EFF who just want to grab everything and nationalise it.

    Or it’s intended to be a ticking bomb for a new President who is going to annoy large chunks of people by either signing it (as they must) or putting it off as long as possible. It’s a no-win for a new President.

    Quite clever actually.

  • Freda Brodie says:

    The bill has now been signed into Law.
    I watched an interview on eNCA news where the DA explained why it will take it to court. The spokeswoman made it clear that they are not against NHI, they are against the way it was passed, public participation input was ignored and so forth. It has to be challenged.
    Yea of no faith in the DA, their legal teams are not stupid, really ?
    I am not ashamed in being a DA supporter, neither should you who do support them.
    Anc has destroyed everything they touched.

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