Negotiations are unlikely to resolve the NHI Act court challenges in the near future. Most organisations taking the National Health Insurance (NHI) Act to court have poured cold water on Finance Minister Enoch Godongwana’s suggestion that litigants should meet the government and “craft a settlement”.
At the heart of the dispute is trust. Several groups argue that the government should have engaged meaningfully during the law-making process, rather than after the President signed the Act. They claim the drafters repeatedly ignored their views during the policy's drafting. Additionally, Parliament ignored these groups during its consideration of the NHI Bill.
NHI Court Challenges: Western Cape Flags Process Defects
Western Cape health and wellness MEC Mireille Wenger said the call for consultation mirrors what Parliament’s process should have delivered in the first place. She argued that the National Council of Provinces failed to enable proper public participation. This is especially significant, given the Act’s major impact on provincial healthcare functions.
For this reason, the Western Cape provincial government says it will continue to seek a court ruling that the process was flawed. It is asking the court to strike down the NHI Act as unconstitutional.
Who Is Suing Over The NHI Act?
The Western Cape is one of eight parties challenging the NHI Act. The others include trade union Solidarity; medical scheme bodies the Board of Healthcare Funders (BHF) and the Health Funders Association (HFA). Also, doctor groupings the South African Private Practitioners’ Forum (SAPPF) and the South African Medical Association (Sama); the Hospital Association of South Africa (HASA), representing private hospitals; and business lobby group Sakeliga.
While these groups differ in tone and demands, most say the state has not shown a willingness to consider alternatives seriously.
Industry Wants Reform, Not This Act
Hasa said it would not have gone to court if the government had engaged in constructive discussion earlier. CEO Dumisani Bomela said the association remains open to improving access to healthcare. But Bomela added that they are only open if the government “fundamentally revisits” its approach to NHI legislation.
The BHF said it had previously submitted proposals to expand coverage, improve affordability, and better integrate public and private healthcare services. It claimed these were blocked. As a result, it says it has no option but to seek clarity through the courts to protect patients and system sustainability.
SAPPF CEO Simon Strachan said his organisation is willing to join “true and open dialogue” on universal health coverage. However, he questioned why the government has not responded to alternatives already submitted.
He pointed to proposals from the Universal Healthcare Access Coalition (UHAC) and Business Unity South Africa (Busa), submitted to the president more than a year ago. Strachan argued that universal health coverage does not require the NHI Act. He also stated that groups would only stop their legal challenges if the government retracted the Act.
The HFA said it will pursue its legal challenge in parallel with any future discussions linked to Busa’s proposal.
Sakeliga went further, calling NHI an “unacceptably extreme proposal” and rejecting the idea that all litigants support universal health coverage under the state’s current design.
Solidarity said it has been willing to negotiate from the start, but only on strict terms. Its position is that it will not settle on anything that includes any form of NHI.
Read the Original Article (May require a subscription)