The DA appears to be reconsidering its intention to challenge the NHI Bill in the Constitutional Court since its entry into the Government of National Unity (GNU), with party leader John Steenhuisen saying he hopes “consensus and collaboration will bring us closer to achieving universal basic healthcare in our lifetime”.
After President Cyril Ramaphosa’s announcement that he would sign the NHI Bill into law before the elections, Steenhuisen had labelled the move as a transparent attempt to “find something – anything” that the President could spin as a populist “solution” to the issues caused by “30 years of ANC misrule”.
He had vowed that the party would challenge the Bill in court, saying that the scale of panic the DA had seen “in response to this announcement is without precedent”, reports News24.
However, with the DA now being a part of the GNU, Steenhuisen has indicated a shift in approach, telling City Press they were working on attempts to find common ground on the issue within the GNU framework.
“I think, at the end of the day, we all want the same thing – universal access to basic healthcare for all South Africans, regardless of economic status,” he said. “We just differ on how to get there.”
He noted that both the private and public healthcare sectors had expressed concerns about the NHI, suggesting these sectors could be strong allies in persuading other GNU members to consider alternative approaches to achieving UHC.
Exodus
The Institute of Race Relations (IRR), meanwhile, has called on Health Minister Aaron Motsoaledi to repeal the Act, warning that its restrictions on medical schemes will increase emigration of SA’s biggest taxpayers and dent the corporate tax take.
SA has only about 862 000 individual taxpayers with an annual income above R750 000, and they contribute 58.6% of all personal income tax paid, said the IRR, citing Treasury estimates for 2024/25.
NHI also posed a threat to corporate income tax, as a flight of skilled mid- to higher-level staff would cause corporate profits to plummet, it added. Business Day reports that only 842 companies in SA generated annual income of more than R100m, contributing almost three-quarters (72.4%) of corporate income tax.
Most people in SA’s highest tax brackets are medical schemes members, and if they flee, in response to diminished access to private healthcare, the state will no longer collect enough revenue to maintain spending on social grants and civil servant wages, or have enough money for infrastructure investment in water, electricity, and transport, said the IRR.
“We would like to see the … Act revoked … and the adoption of low-cost benefit options [for medical schemes], which the government through the council for medical schemes has been blocking,” said IRR campaign manager Majone Maja.
“There are various solutions on the table for universal health coverage. NHI in its current form is not one.”
The Minister’s comment last week that he would not compromise on section 33, even if it meant the end of the GNU, was at odds with his offer to consult stakeholders in a national NHI roadshow, added Maja. Disregarding grievances about section 33 would reduce the roadshow to a tick-box exercise, with no genuine discussion or negotiation.
“Dialogue is effectively defeated. There is no point in continuing the roadshow if NHI will be jammed down the throats of stakeholders.”
See more from MedicalBrief archives:
Minister opens up NHI discussions with roadshow
Pinning down the real cost of the NHI: SA tax expert
Low-cost schemes will soften NHI tax burden, argue medical schemes