KENNETH JACOBS | Opponents of NHI are inconsiderate of the poor

File photo
File photo
Image: Lubabalo Lesolle/Gallo Images

When opponents of the National Health Insurance (NHI) criticise this legislative intervention they do not tell how the multiple tier healthcare system advances the interests of poor black South Africans and if not, until when should the status quo remain.

The source of comfort however is that the opposition to the law is not so much on what and how parliament processed it and public participation. But also, the opposition is not on the need for an egalitarian healthcare system which the NHI is about.

In simple terms, the NHI is a scheme intended to broaden access to healthcare in the country. It is a schedule 3A entity, that will be administered as a fund, whose governance will have a board of directors that report to the minister. In the scheme it will not matter if one has money or not as the fund will be a single purchaser and a single payer. All that is required is that health practitioners will be able to claim from the fund.

The NHI Bill exhaustively followed all parliamentary processes and a very adequate public participation, in the provinces and virtually. South Africans raised their views and they were heard. In the ordinary course of legislation making, public input is bound to vary. The trick is to accommodate and reflect the majority view, not necessarily the dominant or the loudest view, which is what happens in legislation.

SA needs to change and the government is doing well in ensuring that the black majority, who are mostly poor, oppressed by the system and alienated, are brought closer to opportunities. This work remains incomplete and is a path the government needs to walk despite the opposition and the noise. This country will transform and black South Africans will also benefit.

The government should never fear making or proposing legislation because of activists with narrow interests and nothing more than seeking to achieve under the democratic government what they could not achieve under apartheid. Parliament must never fear processing these progressive pieces of legislation merely because there may be opposition to them.

Opposition to progressive pieces of legislation is consistent and coming from the side of the rich or those regarded as well off. This opposition manifested, for example, in bills such as National Minimum Wage, Road Accident Fund Bill, Employment Equity Amendments, Political Party Funding Bill and recently the Basic Education Laws Amendment.

The question is why it seems that when progressive legislation is being proposed, a section of the population, including professionals, prefer that the status quo remains.

This opposition to NHI seems to be driven by selfish and partisan interests, protection and preservation of a service for a few as opposed to the general population, ironically to achieve political mileage that they accuse the president of seeking to advance.

SA remains the most unequal society in the world and certainly the government will not be part to any efforts to perpetuate that. Governance means dealing with that challenge.

It seems lobbying has been enhanced among the living standard measurement (LSM) 9-10, with mobilisation occurring all over the media. Beneficiaries of the private healthcare system who have medical aid could access the reserved health facilities. Those struggling and who cannot afford quality healthcare are mostly black and poor.

The opponents of NHI are not proposing anything as an alternative to structurally deal with this situation. It is selfish and not worth consideration.

As we move from the public signing of this legislation, it would be ideal to have a public implementation with all the necessary regulations, of which failure to comply will and should be accompanied by serious consequences. The funding must come later.


  • Jacobs is the chairperson of the portfolio committee on health.

Would you like to comment on this article?
Register (it's quick and free) or sign in now.

Speech Bubbles

Please read our Comment Policy before commenting.