National health insurance

Show your discontent with NHI by sending AfriForum’s commentary to Parliament:

What is National Health Insurance (NHI)?

The NHI is a central fund that the state wants to create, which will be executed by the various provincial health departments. The NHI-programme will be funded through additional tax revenue. The public can still belong to their own medical aid, but medical aids will only be able to cover healthcare treatment not provided by the NHI. The state will also make use of the services of private medical facilities and will exercise price control over medication and services. This effectively means that the state will be in control of the entire healthcare sector.

The Problem with National Health Insurance

AfriForum argues that the NHI is yet another unrealistic and socialistic state project that will limit and ultimately destroy the freedom of the public (as healthcare consumers), as well as the freedom of doctors and other healthcare practitioners (as the suppliers of healthcare). The NHI will destroy the private healthcare sector, and all service delivery will be lowered to the level of our current public healthcare sector. This will mean that everyone in the country will ultimately be subjected to poor state services due to affordability reasons.

AfriForum furthermore views the NHI as a direct attack on the middle class and on quality healthcare in South Africa. We also view this as a desperate attempt to compensate for the self-created mess in the public healthcare sector. There are also too few taxpayers in the country to fund the NHI, and the economy is growing too slowly to make the NHI sustainable. As a result of a shortage of healthcare practitioners, medicine and people to fund the NHI, healthcare will ultimately be more expensive for everyone. The implementation of the NHI will further cause a previously unseen exodus of skilled healthcare professionals. In June 2021, the South African Medical Association warned that as many as 38% of its 12 000 members planned to emigrate if the NHI were to be implemented. In addition to this, a further 6% planned to emigrate for other reasons and a further 17% said they were unsure about leaving the country if NHI were to be implemented.

The damning findings of the Zondo Commission in which widespread state capture was exposed should serve as enough of a deterrent to not monopolise yet another sector. It should be noted, however, that the NHI will be managed on a much larger scale than other state-owned enterprises, opening the door for even greater failure and financial losses. As such, despite the government’s usual empty promises, there is absolutely no guarantee that the NHI will not go the same way as other state-owned enterprises. With this considered, the NHI amounts to nothing but irresponsible gambling with the health sector, and therefore with millions of South Africans’ lives.

What is AfriForum Doing?

AfriForum is actively fighting to stop the NHI Bill in its tracks. The Bill was tabled in Parliament by former Minister of Health Dr Zweli Mkhize in 2019. This was the first step to ratify the Bill as an Act. The Bill was then referred to the Portfolio Committee on Health. During this stage AfriForum submitted detailed and extensive commentary in opposition to the proposed legislation. AfriForum also made an oral presentation to the Portfolio Committee on 15 February 2022. The Portfolio Committee concluded the public hearings on the National Health Insurance Bill on 24 February 2022 and will now consider the commentary it received. AfriForum pledges to continue applying public pressure on the government to withdraw the NHI Bill and is ready to fight against its implementation in the highest courts if necessary.


Dr. Eugene Brink

Monique Taute

Natasha Venter’s interview on ENCA

NHI Part 1: Potential economic disaster for South Africa | Mike Schüssler

NHI Part 2: To spend more money on the problem is not a solution | Mike Schüssler

NHI Part 3: Health care capacity limitations | Mike Schüssler

NHI Part 4: Focus on repairing the current system first | Mike Schüssler

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