Business Unity South Africa (Busa) has expressed optimism following its meeting with President Cyril Ramaphosa and other government officials to discuss the National Health Insurance (NHI) Act. Busa welcomed the government’s openness to engage on the contentious legislation and, at the president’s request, will submit a proposal to address its concerns.
The meeting, attended by President Ramaphosa, Health Minister Aaron Motsoaledi, Deputy Minister Joe Phaahla, and senior officials from the Department of Health, marks a significant step in fostering collaboration between the government and the private sector on healthcare reform.
Busa Calls for Amendments to the NHI Act
Busa CEO Cas Coovadia said the organisation clarified its position, expressing concerns about certain sections of the NHI Act. “We would like to engage and see if we can reach agreement on some amendments to those sections,” Coovadia stated. Busa’s primary objective is to ensure the NHI Act is “workable, affordable, and implementable,” advancing universal health coverage and fostering an equitable healthcare system.
The NHI Act is central to the ANC’s plan for universal health coverage. It is designed to provide eligible patients with free healthcare at the point of delivery. It establishes a government-controlled NHI fund tasked with purchasing services from accredited public and private healthcare providers. Eventually, the Act will limit medical schemes to offering coverage only for services not covered under NHI.
Proposals to improve healthcare access
In addition to discussing potential amendments, Busa proposed that the government explore other measures to enhance healthcare access. These include ideas Netcare CEO Richard Friedland raised at a recent private hospital industry conference. Friedland, representing the Hospital Association of SA, suggested mandatory medical scheme membership for all formal employees, alongside a risk-equalisation fund to ensure fair competition among schemes.
This proposal could increase the number of medical scheme beneficiaries from 9.2 million to 27.5 million, significantly reducing the number of people reliant on the public healthcare system. Stats SA’s 2023 General Household Survey shows that 26.3% of the population turns to private healthcare first, despite only 15% of the population being medical scheme members.
Busa’s concerns about the NHI Act
While Busa supports the goal of universal health coverage, it remains concerned about the potential impacts of the NHI Act on healthcare quality, taxpayers, the economy, and investor confidence. The organisation previously made several submissions during public consultations, many of which were largely ignored.
However, following the meeting, the presidency reiterated the government’s commitment to ongoing engagement with stakeholders, stating, “We remain dedicated to finding workable solutions that will advance quality and affordable healthcare for all.”
The dialogue between Busa and the government is a positive step toward refining the NHI Act to ensure it meets the needs of South Africans. By fostering collaboration between the public and private sectors, there is hope for a more equitable and accessible healthcare system.