The Hospital Association of South Africa (Hasa) is the latest healthcare body to voice ire against the National Health Insurance Bill, labelling the approval of the bill by the parliamentary health committee without recommendations and contributions made during the parliamentary public hearings as “deeply regrettable and a missed opportunity”.   

“The healthcare reform decisions taken now will impact the sustainability of South Africa’s health system and will be deeply felt for generations to come.” 

The private hospital body said ignoring many dissenting voices concerning the governance of the NHI fund and efficiency concerns in an unstable economy and a corrupt country such as South Africa is short-sighted and “highly unwise”. 

“Passing such vast, complicated, risky, and consequential legislation requires confidence, trust and collaboration among all stakeholders. The approach taken undermines confidence and poses a threat to trust.” 

Recently parliament’s portfolio committee on health adopted its amendments to the bill, after minor changes, paving the way to much anticipated but controversial universal health coverage, National Health Insurance (NHI).

The legislation proposes a single state-run medical fund that will purchase health services on behalf of all patients from public and private sector service providers. While it has been claimed the rich will subsidise the poor, it is not clear how the scheme will be financed. 

Hasa said as public hearings demonstrated, there is broad support for universal access to quality healthcare.

“There is a willingness to engage with the government to collectively craft the best possible legislation.” 

The country’s largest medical scheme, Discovery Health, has also expressed concern about the passing of the bill with few changes, with CEO Ryan Noach saying it is likely the bill will be challenged legally and might be contested on constitutional grounds. 

The South African Medical Association (Sama) rejected the 2019 bill in its current form.

Sama spokesperson Dr Mvuyisi Mzukwa said there are significant concerns regarding provision of healthcare to patients should the bill be taken forward. 

While universal health coverage as envisaged in the objectives of the bill intends to improve the health of South Africans, the bill in its current form “sets up the healthcare system for failure at the expense of further deterioration of the health and wellbeing of all who live in the country”.

Mzukwa said trust in government's ability to efficiently manage the more than R500bn budget was severely eroded, particularly due to the mismanagement of Covid-19 funds.

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