South African Medical Association Rejects NHI Bill as it Now Stands

The South African Medical Association (SAMA) issued a statement stating that they reject the current form of the National Health Insurance (NHI) Bill, with a major objection being that the mere establishment of the NHI fund does not embody the Constitutional principle of universal health coverage (UHC).

The NHI Bill is designed to provide one pool of healthcare funding to all South Africans and long term residents.

They state that the NHI Bill was developed without regard to expert concerns and opinions, especially on key issues such as Contracting Units for Primary Healthcare (CUPS), Benefit Packages and Reimbursement Models.

Given the mismanagement of COVID funds by the government and state-owned entities, there is further concern over its ability to regulate the R500bn fund.

SAMA spokesperson Dr Mvuyisi Mzukwa said: “Misappropriation of funds in various state-owned entities casts doubt on government’s ability to handle the health care budgets responsibly. The public, alongside healthcare stakeholders, cannot simply entrust their lives to a government with an established history of financial mismanagement.”

SAMA contends that while the UHC is intended to improve the health and livelihoods of all South African citizens, the Bill as it stands will set the healthcare system up for failure.

“SAMA believes that a robust approach to health systems strengthening is indispensable, as it would rectify the current deficiencies and overcome the challenges posed by the NHI,” the statement concludes. “This approach seeks to enhance the efficiency, effectiveness, and resilience of the healthcare system, ensuring the delivery of optimal care to all individuals. Governance within the healthcare sector must be strengthened, with transparency and accountability at its core. Effective management of funds and meticulous budget allocation is imperative to rebuild trust and demonstrate responsible stewardship of public resources.”