IRR supports HASA’s legal action against the NHI Act

Eight months after the National Health Insurance Act became law, South Africans still have no clue about how much their taxes will be increased by to fund the scheme.

This is one of the key reasons why the Institute of Race Relations (IRR) supports the Hospital Association of South Africa (HASA) in instituting legal proceedings against the Minister of Health to have the law set aside and declared unconstitutional.

This comes a week after Minister of Finance Enoch Godongwana disclosed that the Ministry of Health had yet to provide a budget for the NHI Act, and could finally see health minister Dr Aaron Motsoaledi being compelled to account for how much more the South African people need to pay in taxes to fund the scheme.

The NHI Act could be the biggest social welfare programme in the country, as, unlike the other welfare programmes, the NHI as currently envisaged aims to force all South Africans into submitting to a government-administered medical aid fund without the option to opt out. Only services not covered under the NHI, which may mostly comprise elective cosmetic treatments, will be excluded from this.

The NHI will require an enormous administrative state and a budget to match. Yet the Minister of Health has not drafted a budget for it and all we have been going on so far are estimates from the private sector.

Says IRR Campaign Manager Makone Maja: “The Minister is not the only one to blame for not being forthcoming about the NHI budget. Parliament, whose responsibility it is to ensure the executive is held to account, failed in its duty to obtain information from the Minister of Health before blindly supporting what could be the biggest budget item on our books.”

The current NHI estimates range from R200 billion at the low end to R800 billion at the higher end. Momentum Health’s estimates far exceed these, at R1.3 trillion, which Dr Motsoaledi has slammed as “mathematical hooliganism”. Anything above R500 billion will see the NHI rocket to become the most expensive expenditure item in our budget.

Long before the NHI even became law, it had already been the subject of a corruption scandal. When the Minister of Health was asked how much NHI advertisements had cost the country from 2019 to date, he revealed that the NHI budget allocation of R77 790 588.80, repurposed for Covid-19 messaging, was spent through Digital Vibes.

Former health minister Dr Zweli Mkhize was reportedly linked to the Digital Vibes corruption investigation concerning a R150 million tender allegedly awarded to friends of his, with Dr Mkhize and his family allegedly benefiting from this contract.

The Department of Health proved itself untrustworthy in running a critical awareness campaign to alert and educate the country about a pandemic without patrimonialism rearing its ugly head. How will it manage the billions more dedicated to life-saving treatments to be delivered under a nationalised healthcare programme?

Dr Motsoaledi rejects low-cost benefit options for reasons that include a claimed lack of research about the population they are intended for; a lack of detail about their implementation; that they will provide inadequate coverage; and, ultimately, that they are not aligned with the NHI.

Yet much of the same can be said about the vagueness and an absence of key details about execution in the NHI plans. Without a financial plan the NHI is reduced to a pipe dream, and South Africans deserve to know how much more of their money is required to make it a reality so that they can make a well-informed decision on whether or not to support it.

The IRR will be urging Dr Motsoaledi to prioritise transparency and accountability with respect to the Act, and parliament to account for failing to exercise its duty to obtain critical information about the NHI from the Minister of Health.

Media contact: Makone Maja, IRR Campaign Manager Tel: 079 418 6676 Email: makone@irr.org.za

Media enquiries: Michael Morris Tel: 066 302 1968 Email: michael@irr.org.za