ANC’s message to medical aid users: Stop ‘resistance’ to R200bn NHI plan

Parks Tau on Wednesday night dismissed criticism of the proposed R200 billion National Health Insurance (NHI) as “resistance” by private healthcare users, who he said were effectively subsidised by the state. 

Tau made the comments while representing the ANC at a national election debate hosted by the Mail & Guardian and the University of Fort Hare in a week in which Health Minister Joe Phaahla confirmed, in a written parliamentary reply, that medical aid tax credits would be revoked to fund the NHI. 

Tau, who is the deputy minister of cooperative governance and traditional affairs, reiterated the ANC’s stance that a single-fund system will follow if President Cyril Ramaphosa signs the NHI Bill, which parliament passed in December. The legislation, he said, aims to ensure equitable access to quality healthcare.

Clause 49 of the bill envisions “tax amendments” to be gazetted by the finance minister to finance the insurance scheme’s single fund, which the treasury says will need about R200 billion to run.

Tau said the country had a two-tier healthcare system — public and private — and the former was “strained” while the latter was more developed.

“But what they [critics] are not saying is that even if you have private health insurance, you get a rebate on your taxes. So the state subsidises your access to the private health system.”

He added that quality healthcare should not only be the preserve of those who could afford the cost. 

“As we seek to implement the National Health Insurance we understand that there will be resistance, because some would want to protect the little that is there. But we are about the majority of the people of this country,” Tau said. 

Siviwe Gwarube, debating on behalf of the Democratic Alliance, agreed that the country had a “two-tier healthcare system”, adding that “poor South Africans have been subjected to a broken healthcare system for decades”.

Gwarube alluded to the unlawful R10 million “bicycle ambulances” championed by axed former health minister Zweli Mkhize during the Covid-19 pandemic — which the Special Investigation Unit set aside after an inquiry found widespread corruption — as evidence of the ANC’s mismanagement. 

“And now you want to open up another SOE [state-owned enterprise] and expect us to trust the wolves in sheepskin? We’re not going to do that,” she said, adding that “it cannot be that people continue to be seen in mud houses [for health facilities]”.

Economic Freedom Fighters deputy president Floyd Shivambu said South Africa should emulate Cuba’s preventative healthcare system to create universal access, saying the Caribbean country “contained diseases before [patients] reached tertiary healthcare facilities”.

“South Africa doesn’t have a healthcare system, it has a hospitalisation system where you wait for people to get sick so that you take them to hospitals,” Shivambu charged.

Inkatha Freedom Party deputy president Mzamo Buthelezi argued that the country still needed to keep state intervention away from the private sector, saying: “You cannot deny any South African his or her right to choose as to where [they] want to be cured.

“If you shut down the private sector, where will people go to be cured?” Buthelezi asked.

Action SA Eastern Cape premier candidate Athol Trollip, a former Nelson Mandela Bay municipality mayor, said his party had Dr Kgosi Letlape, an ophthalmologist and former chair of the South African Medical Association, as its health expert, who would forge a “partnership between the private and public health systems; get them to work together”. 

“Because at one stage in the history of this country, both of those systems were acclaimed — they had some of the best doctors in the world,” Trollip said, adding that public representatives and MPs should be forced to use state health facilities so that they would be improved.