Media release: National Assembly’s deliberation on insidious NHI Bill a potential threat to healthcare freedom


12 June 2023

Mike Settas
083 273 9512

Debbi Scholtz

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National Assembly’s deliberation on insidious NHI Bill a potential threat to healthcare freedom

As the National Assembly debates and votes on the National Health Insurance (NHI) Bill on Tuesday, 13 June, the Free Market Foundation (FMF) anticipates that this unworkable and unaffordable scheme will be adopted, mirroring the reckless approval of the Bill by the health portfolio committee on 25 May.

There are holdouts of excellence in healthcare in South Africa, most of which are in the private health sector. The NHI scheme, if adopted, would likely ensure that the problems that characterise the public healthcare system are transplanted to the private sector. The National Assembly would be committing a grave error if it approves the NHI and refers it to the National Council of Provinces. Instead, the Bill must be voted down.

Chair of the FMF Health Policy Unit, Michael Settas, says “The NHI policy remains predicated on discredited socialist ideologies such as monopolistic centralised state control, the subversion of the constitutional rights of healthcare workers and citizens for the sake of this ideology, as well as the naïve belief that throwing more taxpayer money into the currently dysfunction public sector will be a silver bullet that magically repairs its very obvious leadership and governance problems.”

The FMF has long opposed the introduction of an NHI scheme if it is premised on crowding out, circumventing, or otherwise undermining South Africa’s private health sector. While it is beleaguered by its own problems, the private sector consistently delivers good quality care compared to its state counterpart.

Research undertaken by Statistics South Africa in the 2015 General Household Survey indicated that users of private healthcare are significantly more satisfied with the service they receive than users of public healthcare. “This is likely even truer today than it was eight years ago,” adds FMF Head of Policy, Martin van Staden.

Taking steps, as the NHI Bill proposes, to bring the private health sector under the effective management of public health authorities threatens to harm the bastions of quality healthcare in South Africa. Instead, government should be focused on fixing the public health system and refrain from spreading its problems to other sectors.

As a permanent measure, and alternative to NHI, government can consider the expansion of private sector cover through amendments to existing insurance regulations, thus allowing lower income members to access high-quality private care at an affordable price. Any regulatory change, however, must have the effect of stimulating free enterprise, not stifling it.

Settas says, “An expanding private health sector is an absolute no-brainer for any government. The more citizens that access private care means government’s limited health resources stretch much further at zero cost to the fiscus.”


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