Business Unity South Africa (Busa) has backed Finance Minister Enoch Godongwana’s call to cool tensions around National Health Insurance (NHI). In fact, Busa seeks an NHI Meeting to ensure there is structured engagement with the Presidency in the first quarter of 2026. The aim is to discuss proposals previously submitted to President Cyril Ramaphosa.
Busa is the largest umbrella body for organised business in South Africa. It is not itself a litigant in the matter of the NHI Act. Yet many of its members are taking the law to court. That makes Busa a key voice in a widening policy and legal standoff, as it seeks an NHI meeting as part of a dialogue process.
Busa chief executive Khulekani Mathe said the group welcomed the Finance Minister’s public push for negotiation. He added that organised business is “keen and ready” to engage when the government reaches out. The remarks follow a National Assembly debate last week. In that debate, Godongwana urged the parties litigating over the NHI Act to seek a settlement.
Proposed Talks Signal Shift In Tone
Busa’s latest comments suggest a possible reset after a period of silence. In late 2024, Busa presented an alternative approach to NHI to Ramaphosa at the President’s invitation. Until recently, it appeared that this submission had been sidelined.
A meeting between Busa and the Presidency was planned for late 2025, but did not take place. Mathe said the Presidency indicated it would be rescheduled. Ramaphosa’s spokesperson, Vincent Magwenya, has now confirmed the Presidency intends to schedule a meeting in the first quarter of 2026. In summary, Busa seeks an NHI Meeting not only to present its proposals but also to ensure a transparent process for future healthcare reforms.
Busa has also signalled it will publish its proposals after that engagement. For now, it is keeping the details confidential. Mathe said the intention was to give the President time to consider the submission before it was made public.
The Road To Compromise
Busa’s stance is consistent. It supports the goal of universal health coverage. But it argues the current legislation is not workable. It wants amendments and has warned about impacts on healthcare delivery, taxpayers, the economy, and investor confidence.
Busa is not alone in proposing alternatives. The Universal Healthcare Access Coalition (UHAC), which represents more than two dozen healthcare organisations, released an alternative plan in late 2024. UHAC has argued for a practical model that fits within existing finances. It proposed a hybrid funding approach that retains a role for medical schemes. It also highlighted governance reforms in the public sector.
For healthcare leaders, the next milestone is clear. If the Presidency meeting happens soon, it could determine whether South Africa moves towards negotiated amendments or deeper legal confrontation.
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