Business Unity South Africa (Busa) has stated that it will not support the National Health Insurance (NHI) Bill, saying the NHI’s source of funding and health care benefits need to be clearly understood before the Bill is adopted by Parliament, as with any Bill that has tax implications.

Busa and Business for South Africa (B4SA) have made written submissions to the Select Committee on Health and Social Services of the National Council of Provinces (NCOP) in respect of the NHI Bill. 

Busa CEO Cas Coovadia explained that while universal health coverage was very important for the future success of the country and economy, he was concerned with the current process and version of the NHI Bill with its “attendant constitutional risks”.

However, Coovadia said that with small but critical changes to the Bill, which allowed the public and the private sectors to work together, as was done during the Covid-19 pandemic, a sustainable and affordable NHI was possible, one that met the health care needs of all citizens, regardless of socioeconomic status.

He explained that the NCOP process offered the country an opportunity to make these changes.

He noted that the NHI Bill created a single government-controlled fund relying entirely on tax revenue that would buy and pay for all health care services for everyone, which included the services of doctors, nurses, specialists, allied health care professionals, hospitals, clinics, ambulance services and medication.

Busa and B4SA stated that the NHI Bill, if adopted in its current format, excluded a collaborative role for the private sector that was critical to the NHI being affordable and sustainable for everyone, undermining the fundamental objective of the NHI, which was to address the current inequality in the South African health care system.

“The government says these services will be free at the point of access, but that it will require an additional R200-billion to fund the NHI. This is an estimate made by the Department of Health in 2011, but independent experts estimate that the amount actually required will be closer to R500-billion. This money has to come from somewhere, and the Department of Health has said it will come from increasing taxes,” Coovadia said.

Chairperson of the B4SA Steering Committee Martin Kingston explained that the submission outlined proposed changes to the NHI Bill which would allow for the active and ongoing involvement of the private health care sector, and which were needed to set the country on the pathway to achieve universal health coverage.

He said these proposed changes were also intended to address the operational and constitutional challenges contained in the Bill, so that once it was adopted the country could proceed with implementation of the NHI without lengthy litigation.

“We saw the benefits of an effective public-private partnership during the Covid-19 pandemic, when the private sector pooled its skills and funding to support government efforts for the benefit of all South Africans. This partnership continues today, where government and business are working together to address problems in the energy, transport and logistics sectors, and tackling crime and corruption. We believe this model, combining public and private funding, can serve as a successful template for ensuring access to quality health care and fostering social solidarity, to ensure no person is left behind,” said Kingston.