The NHI seeks to achieve universal healthcare coverage by completely overhauling South Africa’s current two-tier system. Ramaphosa signed the bill just before the May election, in which his African National Congress forfeited its parliamentary majority.
In a speech on Tuesday evening at the conclusion of an ANC policy meeting, Ramaphosa stated, “We have highlighted the social and economic value of affordable, accessible, quality health care that is available equally to all South Africans. We will therefore proceed with the implementation of the National Health Insurance.”
Earlier on Tuesday, Health Minister Aaron Motsoaledi declared that the section of the bill describing transitional mechanisms would be implemented “immediately”.
This involves establishing advisory committees and updating other health-related laws to align with the NHI.
The ruling will progressively reduce the role of private insurance, create a public fund to offer free access to healthcare for citizens, and regulate the fees and prices private healthcare providers can charge for NHI-funded services.
Proponents argue it will address long-standing inequalities from the apartheid era, while critics, including major local health insurers, contend that the proposed funding model is unworkable.
Motsoaledi expressed his willingness to address stakeholder concerns and clarify the NHI’s benefits. “The truly poor, who stand to benefit, have not been heard,” he noted. “No one is amplifying their voice.”
One of the bill’s opponents is the Democratic Alliance (DA) party, traditionally pro-business, which has joined the ANC in government.
Last month, DA leader John Steenhuisen acknowledged that the NHI remains a contentious issue within the coalition government and that discussions are ongoing.
Motsoaledi also noted that the bill would be introduced in stages over the coming years and admitted that legal disputes could potentially delay its implementation.