President Cyril Ramaphosa has officially signed the NHI Act. (Amanda Koza/News24)
Cyril Ramaphosa signs the likely unconstitutional National Health Insurance Act knowing, and perhaps hoping, that it will thwart an all-powerful legal battle by the private sector, writes . News24 editor.
What is somewhat lost in the current outrage over the National Health Insurance (National Health Insurance) is the fact that this cannot continue as it is.
Membership in health systems is becoming increasingly unaffordable due to high medical cost increases, and high medical inflation and little membership growth are straining business models.
Only 16% of South Africans already subscribe to medical aid. On the other hand, 80% of the country's doctors depend on this small population, creating an uneconomical situation for professionals whose livelihoods depend on a small group of economically disadvantaged patients.
Immediate solutions are needed to expand the circle.
The NHI bill was signed into law by President Cyril Ramaphosa on Wednesday.
What it is: A cynical campaign.
President Ramaphosa signed this likely unconstitutional law knowing, and perhaps hoping, that an all-powerful legal battle by the private sector would thwart it. Government finances are already in dire straits and South Africa cannot afford the huge costs of implementing national health insurance.
But his plays would cost a fortune.
The costs of the fight will ultimately be recovered from taxpayers, patients in private healthcare, and participants in the healthcare system.
Read | Peter du Toit: Greedy Ramaphosa delivers destructive NHI for 'Zuma moment'
For the ANC, this is a small price to pay for votes.
Gauteng Premier Panyaza Lesufi has already promised voters free access to private hospitals after the election.
National Health Insurance's broad intentions are a good thing. This will give the private sector a new large patient base and improve its sustainability and affordability. States also pay less for health care than the private sector, and pooling all health care costs can result in significant cost savings.
In theory, current health plan members wouldn't pay more for the same coverage, but they wouldn't be able to see a specialist without a referral.
However, the current bill is unworkable. This would centralize all functions in the state, for example, barring the health system from helping to administer the R1-trillion-a-year scheme.
There is simply no way that the government, which has brought about horrific dysfunction, mismanagement, and rampant corruption to public health care, could run the National Health Service on its own.
Ramaphosa and the ANC know this and don't care. More than that, in a cynical populist move, President Ramaphosa is using the opportunity to attack the “rich wealthy” and “white people” who oppose national health insurance.
It's election season, and politicians go to politics. But intentionally signing this bill to garner votes poisons our democracy.
And ultimately it will backfire against the ANC.
It will take four years for everyone to have access to the NHI, after which it will probably only cover primary health care services. By the time the next election rolls around, they will have little to show for this cheap and dangerous maneuver.
