JOHANNESBURG – South African President Cyril Ramaphosa signed a bill into law on Wednesday that aims to overhaul the healthcare system and address deep inequalities. However, the new law faces legal challenges from critics.
The legislation introduces National Health Insurance (NHI), which will fund access to private healthcare for all South Africans. Currently, 80% of the population relies on overburdened public health services, while about 16% access private healthcare through medical aid plans.
South Africa’s unemployment rate is 32.9%, with most of the Black majority population unable to afford private healthcare. Public health facilities often suffer from long lines and medicine shortages.
President Ramaphosa stated that the goal of NHI is to provide quality healthcare for all and integrate the health system. “The National Health Insurance is a commitment to eradicate the stark inequalities that have long determined who receives adequate healthcare and who suffers from neglect,” he said.
Opposition parties accuse Ramaphosa of using the law as a campaign strategy, noting its announcement just two weeks before highly anticipated elections on May 29. This election is expected to be one of the country’s most contested, with Ramaphosa’s ruling African National Congress possibly receiving less than 50% of the vote for the first time since coming to power in 1994.
Critics have raised concerns about the affordability of the law and potential tax increases needed to fund it. The official opposition Democratic Alliance announced it would legally challenge the new law. Civil society group AfriForum also plans to challenge its constitutionality, while some business forums have described the law as unworkable and unaffordable.
The Health Funders Association, representing stakeholders in private healthcare funding, stated that the plan would take significant time to implement. “There will be no immediate impact on medical scheme benefits and contributions, nor any tax changes. The HFA is well prepared to defend the rights of medical scheme members and all South Africans to choose privately funded healthcare, where necessary,” spokesman Craig Comrie said.
However, the law has also received support. Dr. Cedric Sihlangu, general secretary of the South African Medical Association Trade Union, said the union has long advocated for reforms to significantly improve patient care and access to health services.
