The poor will likely suffer more under the proposed national health insurance (NHI) system, the Democratic Alliance (DA) said on Monday.

"Our research shows that, not only are there serious doubts around the feasibility of the NHI, but that it will actually work against its stated objective to provide improved quality health services for all South Africans," DA spokesperson Mike Waters told journalists at Parliament.

"We believe that the poor will suffer more under the NHI because it will divert billions of rands from other development challenges such as provision of basic services, education, and housing."

NHI would also create a bureaucratic and inefficient healthcare superstructure that would diminish the quality of public healthcare.

There were a number of specific reasons why NHI would not improve the quality of healthcare to the poor.

Among other things, NHI did not fix the real problem of low-quality healthcare provision in the public sector.

Instead, the green paper focused on accessibility and finance, when there already was universal accessibility and enough funding to run a quality public health system.

What it lacked was quality, which should be the government's main priority.

NHI did not adequately attend to accountability and management structures.

The ministerial task team report on healthcare funding stated: "No part of the health system is held properly accountable for poor health outcomes or poor service delivery."

While the green paper called for an Office of Standards Compliance, its members would be appointed by, and would answer to, the health minister.

"It will not be truly independent, making it vulnerable to political influence," Waters said.

Human resources were lacking to introduce NHI, which demanded that the current 27 000 doctors be tripled.

Creation of a centralised fund would also over-bureaucratise the public healthcare system, rendering it more inefficient and costly than it was currently.

Throwing money at a problem did not always solve it.

South Africa spent R2 766 on public healthcare per person each year – far more than other developing countries.

Malaysia, for instance, spent only R2 180 per capita, Thailand just R1 700 per capita, Namibia only R1 594 per capita, and China a mere R846 per capita.

"These countries enjoy higher levels of life expectancy than South Africa, which suggests that money is not the primary problem with our public healthcare system."

The DA believed there was a better way.

By strengthening the positive elements of the public sector and removing its deficiencies on a planned and sustained basis, healthcare could be improved for everyone.

"That is the lesson we have learned in the Western Cape," Waters said.