Business laments government’s lack of interest in NHI talks

SA’s biggest umbrella body for organised business says it is disappointed by the government’s apparent lack of interest in talks on the National Health Insurance (NHI) Act and the tone of the rhetoric directed at parties questioning whether it is the right approach for delivering universal health coverage.

“Raising these concerns is not only appropriate but in fact the responsible and necessary course of action to ensure that the path we choose as a country is both viable and sustainable,” said Business Unity SA’s (Busa) CEO Cas Coovadia on Thursday.

Busa’s comments follow an address given by health minister Aaron Motsoaledi to the International Pharmaceutical Federation Congress on Monday, in which he said fearmongering about NHI was akin to the tactics employed by the apartheid government to frighten the white minority about the supposed security threat posed by the black majority.

“Unfortunately in my country this [universal health coverage] has raised fire and fury by those who wrongly believe that the elevation of others is automatically the downfall of fortunes for those who have already arrived — those who are clear beneficiaries of the present grossly unequal system,” he told delegates at Monday’s conference. The “screaming headlines” in the SA media were designed to scare people off and make them angry about NHI, he said.

The NHI Act sets in motion a series of reforms intended to achieve the ANC’s plan for universal health coverage which aims to provide eligible patients with care that is free at the point of delivery. It paves the way for the establishment of a government-controlled NHI fund that will purchase services from accredited public and private providers for eligible patients, and says medical schemes will ultimately be restricted to offering only cover for services not provided under NHI.

Busa lobbied hard against the NHI Bill when it was before parliament and petitioned the president not to sign it into law after it was approved by the legislature in December 2023. Its attempts to enter further discussions with the government on NHI have been rebuffed, despite President Cyril Ramaphosa signalling in his opening of parliament address in July that there was scope to compromise.

“We are disappointed that despite commitments by the government to engage on the NHI Act, structured discussions have not yet taken place. It is only through formal, constructive engagement with the president, minister of health and National Treasury, focused on collaboration rather than division, that we will create a healthcare system that is equitable, effective and sustainable for generations to come,” said Coovadia. 

In a separate development Motsoaledi defended his decision to conduct a national roadshow on NHI, saying it was his prerogative as minister to engage with the public on any aspect of his portfolio. “I can talk about anything in health, NHI included. I can go out and talk about HIV, I can go out and talk about diabetes,” he said at an NHI summit sponsored by Sizwe Hosmed medical scheme and its administrator, 3Sixty Health, on Thursday.

Motsoaledi’s roadshow plans were met with scepticism from organised business, the DA and trade union Solidarity when they were announced in August, and he was quizzed about its cost in parliament on Wednesday. The minister declined to answer DA MP Michele Clarke’s questions, saying “I’ve got the right to go out to talk to anybody about any programme of the department, including NHI. I don’t owe you any explanation.”

kahnt@businesslive.co.za