IRR urges NCOP to vote against the NHI Bill

The Institute of Race Relations (IRR) has warned the National Council of Provinces (NCOP) that approving the National Health Insurance Bill will trigger an exodus of doctors and other health professionals who fear the NHI will “destabilise” healthcare rather than bring improvements.

In its letter to the NCOP this morning, the IRR said it was clear that many South African health professionals would be reluctant to subject themselves to the NHI’s comprehensive controls over their treatment decisions, and their fees.

The recent South African Medical Association petition to the NCOP (signed by more than 52 000 members) calling for it to vote against the NHI Bill is a clear indication that many healthcare professionals are against the NHI.

In addition, many important questions remain unanswered regarding the implementation of the proposed health scheme. For instance, its costs have never been properly quantified but are likely to be very high. As former health minister Dr Zweli Mkhize told Parliament in August 2019, it will not be enough to combine the amount being spent on health in the public sector (R220bn in 2019/20) with the amount being spent in the private sector (R250bn in that financial year), as a higher annual sum will be needed.

Last month, Minister of Health Joe Phaahla stated that taxpayers would pay for the NHI. The burden of new payroll taxes and surcharges on income tax will fall heavily not only on the middle class but also on the poor. A lingering concern is that much of the revenues raised in this way may not be used for the NHI at all – as the “ring-fencing” of these monies will require a separate statute that the National Treasury is reluctant to enact. The initial tax burden may thus increase by 66% (in real, or after-inflation, terms) over the next 20 years, as has happened in Canada with its “single-payer” system.

The National Treasury warned in its October 2019 medium term budget policy statement that NHI costs were “no longer affordable”, given the country’s current “macroeconomic and fiscal outlook”. This echoes an earlier warning by the Davis Tax Committee, which stated in 2017 that the NHI was “unlikely to be sustainable” without faster economic growth, which has not transpired and is unlikely to be achieved without serious economic reforms.

Said Mlondi Mdluli, IRR Campaign Manager: “There is an urgent need to improve South Africa’s healthcare system and make it more accessible. However, introducing the NHI Bill will not only fail to solve the country’s healthcare problems, but will likely make them worse. It would be irresponsible for members of NCOP to vote in favour of the NHI Bill in the face of the crucial warnings we list in the letter we sent to members today, and considering the petition by the South African Medical Association.”

Media contacts: Mlondi Mdluli, IRR Campaign Manager Tel: 071 148 2971 Email: mlondi@irr.org.za

Marius Roodt, IRR Head of Campaigns Tel: 082 799 7035 Email: marius@irr.org.za

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

Sinalo Thuku, Tel: 073 932 8506 Email: sinalo@irr.org.za