NHI in a nutshell

todayMay 17, 2024 90

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As the debate rages on over whether South Africa will be able to handle the implementation of the National Health Insurance (NHI) system, these are the things you need to know about how you will be affected as a citizen.

The system will see the creation of a state fund to cover the medical costs of all South Africans.

What does this mean?

  1. All South Africans will be treated at all NHI-contracted health facilities regardless of their financial status.
  2. Government says South Africans pockets will be alleviated as the cost of getting care will be reduced.
  3. The bill also makes provision for South Africans to not be charged when they visit healthcare facilities, because the NHI fund will cover the costs of people’s medical care.
  4. South Africans will no longer be required to contribute directly to a medical health scheme to get quality health care.

How will the NHI be funded?

  • General taxes,
  • Contributions of persons earning above a set amount, and
  • Monthly contributions made by the employees to the fund.

Government has also emphasised that those who would still want to be on medical aid schemes, will be allowed to stay on as the NHI is not meant to replace the schemes.

Speaking at the signing event on Wednesday, President Cyril Ramaphosa reiterated that the NHI is an opportunity to break the inequality and inefficiency that has long characterised the approach to the health of the South African people.

It will also reduce the cost of quality healthcare system in the country.

“The NHI is an important instrument to tackle poverty. The rising cost of healthcare makes families poorer and by contrast, health care provided through the NHI frees up resources in poor families for other essential needs.”

Despite the positive sentiments from some sectors, there’s been a pushback from those who feel that the country is not equipped to implement this system.

Opponents including, the Democratic Alliance, are preparing to take the law to court for review.

The DA’s Siviwe Gwarube says the NHI Act does not address systemic issues in the healthcare system.


The EFF has rejected the new law as misguided, disingenuous, and opportunistic.

The party believes the private sector is not a solution to fix South Africa’s broken public healthcare.

“There is a shortage of medical officers, nurses, and community health workers, while trained and qualified medical practitioners are sitting at home doing nothing but willing to work because of joblessness.”

Azapo spokesperson, Jabu Rakwena, says although they believe the system is needed in South Africa; they are skeptical that the ANC-led government can make it a success.

Health expert, Dr Avashri Harrichandparsad, has described the assenting of the bill as a welcome effort by government to address the prevailing inequities in healthcare.

Speaking to Ynews, the Public Health Medicine Specialist in Public Health Medicine at UKZN, however, raised concern that the new law focuses primarily on the financing and doesn’t adequately address the challenges in all other aspects of the health system, like governance, human resources, service delivery, medicine vaccines and technology, among others.

South Africans also have mixed feelings over the scheme, whose full implementation is projected to take at least 30 years.

Medical schemes have meanwhile assured their members that NHI is a long way off and urged them not to panic but continue with their current healthcare arrangements.

Written by: Nonhlanhla Harris

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