Influential Stakeholders Driving the National Health Insurance (NHI) in South Africa

The Influential Stakeholders Driving the National Health Insurance (NHI) in South Africa

There are vested interests behind implementing the National Health Insurance (NHI) scheme in South Africa, which aims to use it to capture parts of the state and drain government resources.

This is feedback from Wits School of Governance Professor Alex van den Heever, who told Newzroom Afrika that the NHI is a threat to both the public and private healthcare systems.

“It is extremely controversial and potentially very prejudicial to the health system as a whole, both the public sector and private sector,” he said.

“The Bill has not been amended despite multiple submissions showing several flaws. And so, it is likely to face strong legal challenges if it is signed.” 

Businesses, through Business Unity South Africa and Business for South Africa, have stated that if the NHI is passed, they will challenge it in court.

According to the business organisations, the NHI is now impractical, unimplementable, costly, and unconstitutional.

Van den Heever stated that the major reason people are anxious about the NHI Bill’s passage is for nefarious reasons.

“The possibilities for corruption are endless. People are largely concerned because they feel that is the purpose behind this – that this is not intended to improve healthcare,” he said.

“It is about vested interests who have an interest in essentially capturing parts of the state.”

He explained that there had already been widespread interference by political actors in provincial health departments.

The looting of funds and resources accompanies this interference. “It is not a resource issue that many provincial health systems are failing – it is that they have had their funds taken.” 

“There is systemic corruption. We are in a crisis in South Africa at the moment where we have syndicates who are extracting resources from the state hand over fist,” Van den Heever said.

He added that nothing would improve healthcare provision in South Africa – not even the NHI – until mismanagement and corruption are rooted out.

“Government services in South Africa are undermined by poor decisions, mismanagement, and systemic corruption,” he said.

“Until we get that right, do not expect a more sophisticated system that you dreamed up to work better.”

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