Parliament passed the controversial National Health Insurance (NHI) Act, paving the way for universal healthcare in South Africa.
The African National Congress (ANC) used its majority in the National Assembly to vote Thursday in favor of the NHI bill.
The Democratic Alliance (DA), Economic Freedom Fighters (EFF) and Inkatha Freedom Party (IFP) were among the parties that voted against the bill.
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The NHI bill proposes that comprehensive health programs fall despite nearly nine million South Africans being members of a medical care.
It also proposes that most healthcare, including doctor visits and medicines, be free for all and that medical schemes are unable to provide coverage for services paid for by the NHI.
The bill also says the government would levy an additional personal income tax on citizens and use the money it saves by not giving tax credits to be a member of a medical scheme.
Ahead of the vote, MPs discussed the proposed legislation, with Health Minister Joe Phaahla lamenting the imbalance between the public and private health sectors.
Phaahla said the bill aimed to prevent “two trains on parallel tracks” from crashing.
“This has led to a situation where the public healthcare system is under enormous pressure while private healthcare over-services its customers, leading to ever-increasing costs for members of the medical system as investors enjoy huge dividends.
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“The reality is that this situation is not sustainable as the number of people in informal jobs is not increasing in line with investment in private healthcare. Medical program membership costs rise above inflation every year, while benefits shrink,” she said.
“All medical professionals are trained for their clinical skills on common South Africans in public health settings, but once qualified they are only accessible to those with money. The availability of the best health professionals to those who have medical assistance, but also the migration to other countries is totally unfair”.
Watch the plenary below:
Deputy District Attorney Michele Clarke labeled the bill “disastrous” as it will destroy South Africa’s health care.
“The ANC could argue that through the NHI fund, private healthcare facilities will serve a large portion of the public previously unable to access their services. However, this is based on the ridiculous assumption that those nine million South Africans will continue to pay for their medical care when it no longer benefits them.
“Without private patient funding, private healthcare facilities will depend on government funding, effectively making them public healthcare facilities without the benefit of a dedicated budget,” he said.
Clarke said he believed the NHI would open the door to corruption, citing the Covid-19 pandemic as an example.
“The NHI is not a miracle as the ANC claims. It is only meant to convince people that the looters have returned to their revolutionary roots, which once liberated a nation.”
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EFF Naledi Chirwa described the bill as “one of the biggest scams” proposed by the ANC.
“The only way to eradicate a two-tier system is nationalization, not healthcare procurement,” he said.
Chirwa accused Phaahla of failing to outline the true cost of the NHI, while Finance Minister Enoch Godongwana also failed to state how the NHI would be financed.
“The NHI does not make it easier for the poor to access healthcare as there is a framework that is encapsulated in the NHI that states that we should all access healthcare at our nearest facility.
“This means that those who live in townships, rural areas, informal settlements will still be subject to public health facilities,” he said.
“The NHI is a direct manifestation of what the Ramaphosa administration truly stands for: the full agenda to privatize everything and make the state useless.”
Read the bill below:
National Health Insurance Bill b 11 2019 by Molefe Seeletsa on Scribd
IFP MP Magdalena Hlengwa said the bill would deny access to health care due to the amount of funding it would require.
Hlengwa warned that the bill, in its current form, would give the health minister powers “beyond political office”.
“This will open the door for undue influence, cadre deployment and oversight with a negative impact,” he said.
GOOD MP Brett Herron said his party supported the bill, even though he acknowledged the legislation wasn’t perfect.
“The goals are good. Potential obstacles to the NHI’s success, including corruption, must be addressed.”
After the debate, 205 lawmakers voted in favor of the NHI bill, while 125 voted against.
The bill will now go to the National Council of Provinces (NCOP), which will open the door for another round of public hearings.
The bill will then be sent to the president for approval.
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