Solidarity’s fight against the National Health Insurance (NHI) Act

What is the National Health Insurance Act?  

National Health Insurance (NHI), under state control, is proposed as the single purchaser of all healthcare in South Africa. One of the most notable problems with this proposition is that as soon as a specific service is covered by the NHI, it would become illegal to receive it through any means other than the NHI. The state would therefore not just be the single purchaser, but would effectively control which health services would be available in South Africa, as well as how and by whom those services may be provided.

In June last year the National Assembly agreed to the National Health Insurance (NHI) Bill making provision for the introduction of the NHI, and in December the Bill was also approved by the National Council of Provinces. Weeks before the national election in May 2024, President Cyril Ramaphosa signed the Bill into law. This Act sets out to offer “free” healthcare to all citizens, including expensive medical procedures currently done in private hospitals. Although it seems like a noble notion, it is however important to note that the free healthcare the government already provides in state hospitals and clinics is already unsustainable and these facilities are in unthinkably awful conditions. The NHI is an unaffordable attempt from the state which would drastically cut the income of its citizens, as it would be mainly funded by a very small number of taxpayers.

The Minister of Finance did not budget for a reasonable amount for the implementation of the NHI, which implies that the Treasury does not foresee the actual implementation of the NHI in the near future. This was also the case with the previous submissions of the Bill, and now, with the Bill having been passed, the officials concerned still did not provide for this constitutional requirement.

Even so, the funding structure proposed in the NHI Bill makes provision for a new payroll tax, as well as for a surcharge on income tax. This is in addition to general tax revenue and a planned re-allocation of provincial budgets and conditional allocations, as well as from tax credits for medical schemes.

If the government projections made at that time are to be believed, the NHI will result in the budget deficit being further increased by about R32 billion. A more realistic calculation, as shown in a research report by the Solidarity Research Institute (SRI), shows a deficit of R295,93 billion as an absolute minimum. Treasury cannot afford a deficit of R32 billion, let alone a deficit of R295,93 billion.

Theoretically, R295,93 billion could be generated by abolishing the medical tax credit (about R30 billion) and levying the following taxes:

  • A 40% surcharge on income tax;
  • Increasing VAT from 15% to 22%;
  • A payroll tax of 13,4%;
  • Increasing corporate income tax from 27% to 45%; and
  • A combination of these.

In real terms, none of these is possible, because the South African taxpayer is overtaxed.

The theoretical examples given here above serve as illustration purposes only and to demonstrate the absurdity of the NHI.

 

The National Health Act and a victory in court

On 24 June 2024 Solidarity managed to have one of the major cornerstones of the proposed National Health Insurance (NHI) pulled down by means of its legal action when the North Gauteng High Court declared sections 36 to 40 of the National Health Act unconstitutional. The court also granted a cost award against the respondents.

According to Solidarity, the state’s goal with these sections in the National Health Act clearly was to pave the way for the NHI.

“The government wants to change to a system in which health care is nationalised and health care practitioners become servants of the state so that the provision of all health care can be centrally controlled by the state. This victory thwarts those disastrous plans,” Solidarity Chief Executive Dr Dirk Hermann said.

Sections 36 to 40 of the National Health Act provide that health care practitioners obtain a certificate of need (CoN) from the Department of Health before they can establish a practice in a specific area.

By declaring these sections unconstitutional, this court ruling will have an impact on the implementation of the NHI Act and will complicate the processes to implement it.

After the court ruling by the North Gauteng High Court, the Minister of Health, Dr Aaron Motsoaledi, denied that the ruling on the National Health Act made the National Health Insurance (NHI) Act vulnerable, denying any connection with the NHI Act while accusing pressure groups of spreading “toxic propaganda”.

However, his own department’s spokesperson, Foster Mohale, was quoted on multiple occasions in the past, reaching this exact conclusion that the two are connected when the sections were first declared invalid in 2022.

“The ruling has serious implications for the implementation of the National Health Insurance (NHI), and the Department of Health will request that the ruling be overturned and will contest the case in the Constitutional Court,” Mohale said at the time.

Hermann says that the government does not have a track record of “doing the right thing,” and Solidarity will therefore be ready to continue the fight in court.

 

What are the implications of the NHI for South Africa?

Dr Eugene Brink, strategic advisor for community affairs at AfriForum, also explored the implications of National Health Insurance in an article published on Solidarity’s platform. He writes that the NHI could be very dangerous if ever fully implemented.

In his article he quotes Bloom Financial Services, which stated that the NHI would destroy comprehensive medical schemes. “Once implemented, medical schemes won’t be able to offer any health services already offered by the NHI. Medical aid will only offer you extra services not covered by the NHI.”

Brink also pointed out that all healthcare funds would be centralised (actually nationalised) in a single state-controlled fund. Given what the government as curator of tax money has caused as a result of blatant corruption and abuse, this is a chilling thought.

The medical aid fund Discovery offers further criticism in this regard, also quoted in Brink’s article: “Our strong view is that limiting the role of medical schemes would be counterproductive to the NHI because there are simply insufficient resources to meet the needs of all South Africans. Limiting people from purchasing the medical scheme coverage they seek will seriously curtail the healthcare they expect and demand. It poses the risks of eroding sentiment and of denuding the country of critically needed skills, and is impacting negatively on local and international investor sentiment and business confidence.”

Brink also refers to Prof. Nicola Theron and Dr Paula Armstrong of FTI Consulting who recently wrote that to insist that the only path to universal healthcare (UHC) is through a single pool of funds managed by the government and the erosion of the role of medical schemes as purchasers of medical services would probably contribute to the demise of a strong and well-functioning private healthcare section. It narrows consumer choice, erodes competition and may even lead to the same outcomes as recent examples of what has become of state-owned enterprises and funds. Read the full article here. 

The National Health Insurance Act would be very dangerous is fully implemented
The National Health Insurance Act would be very dangerous is fully implemented

No end in sight for the fight against the NHI yet

“Solidarity is vehemently opposed to the NHI and is strongly in favour of a market approach, offering a choice to private service providers and to the public, while at the same time being in favour of an improved public healthcare system. NHI will ruin South Africa and Solidarity is preparing for a major court battle to ensure that the healthcare sector is free, safe and prosperous,” Brink concluded his article.

 

 

 

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Slot

Geskiedenisfonds

ʼn Fonds wat help om die Afrikanergeskiedenis te bevorder.

FAK

Die Federasie van Afrikaanse Kultuurvereniginge (FAK) is reeds in 1929 gestig. Vandag is die FAK steeds dié organisasie wat jou toelaat om kreatief te wees in jou taal en kultuur. Die FAK is ’n toekomsgerigte kultuurorganisasie wat ’n tuiste vir die Afrikaanse taal en kultuur bied en die trotse Afrikanergeskiedenis positief bevorder.

Solidariteit Helpende Hand

Solidariteit Helpende Hand fokus op maatskaplike welstand en dié organisasie se groter visie is om oplossings vir die hantering van Afrikanerarmoede te vind.

Solidariteit Helpende Hand se roeping is om armoede deur middel van gemeenskapsontwikkeling op te los. Solidariteit Helpende Hand glo dat mense ʼn verantwoordelikheid teenoor mekaar en teenoor die gemeenskap het.

Solidariteit Helpende Hand is geskoei op die idees van die Afrikaner-Helpmekaarbeweging van 1949 met ʼn besondere fokus op “help”, “saam” en “ons.”

Forum Sekuriteit

Forum Sekuriteit is in die lewe geroep om toonaangewende, dinamiese en doeltreffende privaat sekuriteitsdienste in

Suid-Afrika te voorsien en op dié wyse veiligheid in gemeenskappe te verhoog.

AfriForumTV

AfriForumTV is ʼn digitale platform wat aanlyn en gratis is en visuele inhoud aan lede en nielede bied. Intekenaars kan verskeie kanale in die gemak van hul eie huis op hul televisiestel, rekenaar of selfoon verken deur van die AfriForumTV-app gebruik te maak. AfriForumTV is nóg ʼn kommunikasiestrategie om die publiek bewus te maak van AfriForum se nuus en gebeure, maar ook om vermaak deur films en fiksie- en realiteitsreekse te bied. Hierdie inhoud gaan verskaf word deur AfriForumTV self, instellings binne die Solidariteit Beweging en eksterne inhoudverskaffers.

AfriForum Uitgewers

AfriForum Uitgewers (voorheen bekend as Kraal Uitgewers) is die trotse uitgewershuis van die Solidariteit Beweging en is die tuiste van Afrikaanse niefiksie-, Afrikanergeskiedenis- én prima Afrikaanse produkte. Dié uitgewer het onlangs sy fokus verskuif en gaan voortaan slegs interne publikasies van die Solidariteit Beweging publiseer.

AfriForum Jeug

AfriForum Jeug is die amptelike jeugafdeling van AfriForum, die burgerregte-inisiatief wat deel van die Solidariteit Beweging vorm. AfriForum Jeug berus op Christelike beginsels en ons doel is om selfstandigheid onder jong Afrikaners te bevorder en die realiteite in Suid-Afrika te beïnvloed deur veldtogte aan te pak en aktief vir jongmense se burgerregte standpunt in te neem.

De Goede Hoop-koshuis

De Goede Hoop is ʼn moderne, privaat Afrikaanse studentekoshuis met hoë standaarde. Dit is in Pretoria geleë.

De Goede Hoop bied ʼn tuiste vir dinamiese studente met Christelike waardes en ʼn passie vir Afrikaans; ʼn tuiste waar jy as jongmens in gesonde studentetradisies kan deel en jou studentwees met selfvertroue in Afrikaans kan uitleef.

Studiefondssentrum

DIE HELPENDE HAND STUDIETRUST (HHST) is ʼn inisiatief van Solidariteit Helpende Hand en is ʼn geregistreerde openbare weldaadsorganisasie wat behoeftige Afrikaanse studente se studie moontlik maak deur middel van rentevrye studielenings.

Die HHST administreer tans meer as 200 onafhanklike studiefondse namens verskeie donateurs en het reeds meer as 6 300 behoeftige studente se studie moontlik gemaak met ʼn totaal van R238 miljoen se studiehulp wat verleen is.

S-leer

Solidariteit se sentrum vir voortgesette leer is ʼn opleidingsinstelling wat voortgesette professionele ontwikkeling vir professionele persone aanbied. S-leer het ten doel om werkendes met die bereiking van hul loopbaandoelwitte by te staan deur die aanbieding van seminare, kortkursusse, gespreksgeleenthede en e-leer waarin relevante temas aangebied en bespreek word.

Solidariteit Jeug

Solidariteit Jeug berei jongmense voor vir die arbeidsmark, staan op vir hul belange en skakel hulle in by die Netwerk van Werk. Solidariteit Jeug is ʼn instrument om jongmense te help met loopbaankeuses en is ʼn tuiskomplek vir jongmense.

Solidariteit Regsfonds

ʼn Fonds om die onregmatige toepassing van regstellende aksie teen te staan.

Solidariteit Boufonds

ʼn Fonds wat spesifiek ten doel het om Solidariteit se opleidingsinstellings te bou.

Solidariteit Finansiële Dienste (SFD)

SFD is ʼn gemagtigde finansiëledienstemaatskappy wat deel is van die Solidariteit Beweging. Die instelling se visie is om die toekomstige finansiële welstand, finansiële sekerheid en volhoubaarheid van Afrikaanse individue en ondernemings te bevorder. SFD doen dit deur middel van mededingende finansiële dienste en produkte, in Afrikaans en met uitnemende diens vir ʼn groter doel aan te bied.

Ons Sentrum

Die Gemeenskapstrukture-afdeling bestaan tans uit twee mediese ondersteuningsprojekte en drie gemeenskapsentrums, naamlik Ons Plek in die Strand, Derdepoort en Volksrust. Die drie gemeenskapsentrums is gestig om veilige kleuter- en/of naskoolversorging in die onderskeie gemeenskappe beskikbaar te stel. Tans akkommodeer die gemeenskapsentrums altesaam 158 kinders in die onderskeie naskoolsentrums, terwyl Ons Plek in die Strand 9 kleuters en Ons Plek in Volksrust 16 kleuters in die kleuterskool het.

Skoleondersteuningsentrum (SOS)

Die Solidariteit Skoleondersteuningsentrum (SOS) se visie is om die toekoms van Christelike, Afrikaanse onderwys te (help) verseker deur gehalte onderrig wat reeds bestaan in stand te (help) hou, én waar nodig nuut te (help) bou.

Die SOS se doel is om elke skool in ons land waar onderrig in Afrikaans aangebied word, by te staan om in die toekoms steeds onderrig van wêreldgehalte te bly bied en wat tred hou met die nuutste navorsing en internasionale beste praktyke.

Sol-Tech

Sol-Tech is ʼn geakkrediteerde, privaat beroepsopleidingskollege wat op Christelike waardes gefundeer is en Afrikaans as onderrigmedium gebruik.

Sol-Tech fokus op beroepsopleiding wat tot die verwerwing van nasionaal erkende, bruikbare kwalifikasies lei. Sol-Tech het dus ten doel om jongmense se toekomsdrome met betrekking tot loopbaanontwikkeling deur doelspesifieke opleiding te verwesenlik.

Akademia

Akademia is ’n Christelike hoëronderwysinstelling wat op ’n oop, onbevange en kritiese wyse ’n leidinggewende rol binne die hedendaagse universiteitswese speel.

Akademia streef daarna om ʼn akademiese tuiste te bied waar sowel die denke as die hart gevorm word met die oog op ʼn betekenisvolle en vrye toekoms.

AfriForum Publishers

AfriForum Uitgewers (previously known as Kraal Uitgewers) is the proud publishing house of the Solidarity Movement and is the home of Afrikaans non-fiction, products related to the Afrikaner’s history, as well as other prime Afrikaans products. The publisher recently shifted its focus and will only publish internal publications of the Solidarity Movement from now on.

Maroela Media

Maroela Media is ʼn Afrikaanse internetkuierplek waar jy alles kan lees oor dit wat in jou wêreld saak maak – of jy nou in Suid-Afrika bly of iewers anders woon en deel van die Afrikaanse Maroela-gemeenskap wil wees. Maroela Media se Christelike karakter vorm die kern van sy redaksionele beleid.

Kanton Beleggingsmaatskappy

Kanton is ʼn beleggingsmaatskappy vir eiendom wat deur die Solidariteit Beweging gestig is. Die eiendomme van die Solidariteit Beweging dien as basis van die portefeulje wat verder deur ontwikkeling uitgebrei sal word.

Kanton is ʼn vennootskap tussen kultuur en kapitaal en fokus daarop om volhoubare eiendomsoplossings aan instellings in die Afrikaanse gemeenskap teen ʼn goeie opbrengs te voorsien sodat hulle hul doelwitte kan bereik.

Wolkskool

Wolkskool is ʼn produk van die Skoleondersteuningsentrum (SOS), ʼn niewinsgewende organisasie met ʼn span onderwyskundiges wat ten doel het om gehalte- Afrikaanse onderrig te help verseker. Wolkskool bied ʼn platform waar leerders 24-uur toegang tot video-lesse, vraestelle, werkkaarte met memorandums en aanlyn assessering kan kry.

Ajani

Ajani is ‘n privaat geregistreerde maatskappy wat dienste aan ambagstudente ten opsigte van plasing by werkgewers bied.

Ajani is a registered private company that offers placement opportunities to artisan students in particular.

Begrond Instituut

Die Begrond Instituut is ʼn Christelike navorsingsinstituut wat die Afrikaanse taal en kultuur gemeenskap bystaan om Bybelse antwoorde op belangrike lewensvrae te kry.

Sakeliga

ʼn Onafhanklike sake-organisasie

Pretoria FM en Klankkoerant

ʼn Gemeenskapsgebaseerde radiostasie en nuusdiens

Saai

ʼn Familieboer-landbounetwerk wat hom daarvoor beywer om na die belange van familieboere om te sien deur hul regte te beskerm en te bevorder.

Ons Winkel

Ons Winkels is Solidariteit Helpende Hand se skenkingswinkels. Daar is bykans 120 winkels landwyd waar lede van die publiek skenkings van tweedehandse goedere – meubels, kombuisware, linne en klere – kan maak. Die winkels ontvang die skenkings en verkoop goeie kwaliteit items teen bekostigbare pryse aan die publiek.

AfriForum

AfriForum is ʼn burgerregte-organisasie wat Afrikaners, Afrikaanssprekende mense en ander minderheidsgroepe in Suid-Afrika mobiliseer en hul regte beskerm.

AfriForum is ʼn nieregeringsorganisasie wat as ʼn niewinsgewende onderneming geregistreer is met die doel om minderhede se regte te beskerm. Terwyl die organisasie volgens die internasionaal erkende beginsel van minderheidsbeskerming funksioneer, fokus AfriForum spesifiek op die regte van Afrikaners as ʼn gemeenskap wat aan die suidpunt van die vasteland woon. Lidmaatskap is nie eksklusief nie en enige persoon wat hom of haar met die inhoud van die organisasies se Burgerregte-manifes vereenselwig, kan by AfriForum aansluit.