Only Parliament can change the National Health Insurance (NHI) by passing amendment legislation. No amount of meetings between President Cyril Ramaphosa and organised business will alter this. However, Ramaphosa is aware of the dissatisfaction with the NHI.
Health Minister Aaron Motsoaledi’s rigid stance has frustrated business leaders. After a meeting with Motsoaledi, Ramaphosa told the National Council of Provinces (NCOP) that he suggested meeting with critics to address their concerns.
NHI is “a great opportunity”
Despite ongoing criticism of the NHI’s flaws, including revenue sources and potential corruption risks, Ramaphosa called it “a great opportunity.” He stressed that reducing the cost of living is a government priority and that he is open to discussing its implementation.
Ramaphosa may use consultations and PR to manage dissatisfaction. Organised business representatives could be included in NHI benefits and health technology advisory committees. But ultimately, this is a political move to maintain power and control public perception.
The President’s approach weakens lawmaking
While popular, the President’s approach to engagement weakens lawmaking. Laws signed by the President should be implemented without delay. Yet, months after the NHI Act was signed, it still hasn’t been proclaimed, raising hope among some business leaders for possible changes.
Public input was allowed during the Parliamentary process, when civil society, health experts, and businesses offered critiques and solutions. However, the ANC pushed the NHI through Parliament, disregarding these.
Ramaphosa’s engagement promises may be politically astute, but set a dangerous precedent. Only Parliament can amend the NHI Act; any failure to implement sections due to engagements would undermine the legislative process. Ultimately, the courts may again need to intervene where Parliament and politicians have failed.