South African President Cyril Ramaphosa has signed on Wednesday a landmark bill into law, paving the way for universal healthcare coverage in the country. This move, coming just two weeks before the general election, is hailed by Ramaphosa as a significant step towards a more equitable society.
The NHI will gradually restrict the role of private insurance, establish a public fund for free healthcare access for South African citizens, and regulate fees charged by private doctors and healthcare providers for NHI-covered services, according to local media.
While supporters view this as a transformative step to address longstanding inequalities rooted in the apartheid era, opponents express concerns about the strain on already stretched public finances, limited patient choice, potential decline in care quality, and the possibility of skilled doctors leaving the country.
Ramaphosa addressed critics, emphasizing that existing healthcare disparities cannot persist. He asserted a commitment to equality in healthcare provision.
"For those who would like to see those privileges continuing, sorry, you are on the wrong boat. The boat we are on is about equality," the leader said at the signing ceremony at the Union Buildings in Pretoria, the government's seat.
Major private health insurers, including Discovery, Momentum Metropolitan Health, and AfroCentric, while supporting the goal of universal healthcare, remain skeptical about the proposed funding model. Concerns about inadequate funding for a comprehensive NHI in its current form, considering the country's economic constraints, are prevalent.
Meanwhile, some labor unions urge the government to fully back the NHI, ensuring adequate resource allocation.
The government said that the National Treasury will determine the NHI funding sources, including a mandatory prepayment system and various taxes.