South African president passes disputed health law

South African President Cyril Ramaphosa has signed into law a bill that aims to provide universal health coverage and address the country’s longstanding disparities in access to medical care.

In his speech at the signing on Wednesday, Ramaphosa described the National Health Insurance (NHI) Act as a “transformational” initiative and a milestone in Pretoria’s efforts for a more just society.

“The provision of health care in this country is currently fragmented, unsustainable and unacceptable,” the president said, adding that “the NHI Bill presents an innovative approach to funding universal healthcare based on social solidarity.”

Currently, 80% of South Africans are reportedly dependent on overburdened public-funded health services, with approximately 16% having access to private healthcare through medical aid plans.

The move comes just two weeks before a national election in which analysts predict the ruling African National Congress (ANC) party could lose its overall majority for the first time since it assumed power three decades ago.

President @CyrilRamaphosa signs the National Health Insurance Bill into law#NHIAct 🩺#LeaveNoOneBehind 🇿🇦 pic.twitter.com/YAOaqScnKG

— The Presidency 🇿🇦 (@PresidencyZA) May 15, 2024

Ramaphosa has pledged in his campaign to end “healthcare apartheid” through the legislation, which aims to ban the private sector from insuring treatment covered under the NHI plan. The government has clarified that the scheme will be funded through the National Treasury, which will include a mandatory pre-payment system and other forms of revenue.

However, concerns have been expressed about the law’s affordability and the possibility of tax increases to fund it. Opponents, including business advocacy groups, claim it is unconstitutional and a vote-buying scheme ahead of the May 29 elections.

“The NHI will not address the issues in our healthcare system; it is financially unfeasible, leading to increased taxes and enabling more corruption,” South Africa’s largest opposition party, the Democratic Alliance (DA), told reporters after the legislation was passed on Wednesday.

The DA says it will challenge the scheme in court.

On Wednesday, civil society organization AfriForum also announced plans to file a legal appeal.