The South African government plans to introduce the National Health Insurance Bill (NHI). This bill is aimed at increasing the quality of healthcare services to all and to ensure equitable access to healthcare services or Universal Health Coverage (UHC).

According to the Health Department website:

The National Health Insurance (NHI) is a financing system that will make sure that all citizens of South Africa (and legal long-term residents) are provided with essential healthcare, regardless of their employment status and ability to make a direct monetary contribution to the NHI Fund.

By definition it is a financing system. Isn’t healthcare funded from taxes already? Indeed. In 2005 South Africa spent 8.7% of its GDP on healthcare. Despite this fact public healthcare is severely underfunded. By this definition also unemployed citizens should receive this benefit even if they are unable to contribute to the NHI fund.

What this means by implication is that anyone who needs a particular medical service, not available at a public hospital, should be able to access such in a private hospital without been required to pay.

According to the National Health Minister Dr Aaron Motsoaledi NHI membership will be compulsory as this is the only way it can be sustainable. Two bills have already been gazetted, the NHI Bill and the Medical Schemes Amendment Bill.


One implication of NHI will be tariff caps on services provided by doctors. While this is great for consumers South Africa stands to lose many skilled doctors. Some have vowed to boycott the bill or legally challenge it.

The NHI Bill is very vague on whether people can buy cover outside of the national NHI scheme, and refers to private cover that is ‘complementary’ to the compulsory NHI cover.


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