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 The bill creating an NHI Fund paves the way for a comprehensive
overhaul of South Africa's health system that would be one of the
biggest policy changes since the ruling African National Congress
ended white minority rule in 1994.
The existing health system in Africa’s most industrialized economy
reflects broader racial and social inequalities that persist more
than two decades after apartheid ended.
Less than 20 percent of South Africa’s population of 58 million can
afford private healthcare, while a majority of poor blacks queue at
understaffed state hospitals short of equipment.
Anban Pillay, deputy director general at the health department, told
reporters an initial Treasury estimate of 206 billion rand costs by
2022 was more likely to be 256 billion rand by the time final
numbers had been reviewed.
The bill proposes that the NHI Fund, with a board and chief
executive officer, also be funded from additional taxes.
"The day we have all been waiting for has arrived: today the
National Health Insurance Bill is being introduced in parliament,"
said Health Minister Zweli Mkhize at the briefing, adding that the
pooling of existing public funds should help reduce costs.
The Hospital Association of South Africa (HASA), an industry body
which represents private hospital groups including Netcare,
Mediclinic and Life Healthcare, welcomed the release of the bill.
"We are committed to, and supportive of, the core purpose of the
legislation, which is to ensure access to quality healthcare for all
South Africans," said HASA chairman Biren Valodia in a statement.
"TAX BURDEN"
The new bill is still to be debated in parliament with public input.
It is unclear how long the legislative process will take, with the
main opposition party Democratic Alliance suggesting the NHI, which
has been in the works for around a decade, would strain the nation's
coffers.
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"The DA is convinced that instead of being a vehicle to provide
quality healthcare for all, this Bill will nationalize healthcare
... and be an additional tax burden to already financially-stretched
South Africans," said Siviwe Gwarube, the DA's shadow health
minister, in a statement.
Successful implementation of NHI would be a boon for President Cyril
Ramaphosa following May's election the ANC won, but its cost comes
at a tricky time in a struggling economy.
South Africa's rand fell to touch an 11-month low on Wednesday,
rocked by deepening concerns about the outlook for domestic growth
with unemployment at its highest in over a decade and the economy
skirting recession.
New taxation options for the Fund include evaluating a surcharge on
income tax and small payroll-based taxes.
"There is no doubt that taxpayers will find the additional tax
burden a bitter pill to swallow," said Aneria Bouwer, a partner and
tax specialist at Bowmans law firm.
The NHI is due to be implemented in phases before full operation by
2026. The government is looking to eventually shift into the new
Fund approximately 150 billion rand a year from money earmarked for
the provincial government sphere.
(Reporting by Onke Ngcuka and Wendell Roelf; Editing by Andrew
Cawthorne)
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