NEHAWU CALLS ON PRESIDENT RAMAPHOSA TO PROMULGATE THE NHI ACT INTO FORCE FOR THE IMPLEMENTATION OF THE NATIONAL HEALTH INSURANCE

The National Education, Health and Allied Workers' Union [NEHAWU] calls on President Cyril Ramaphosa to promulgate the National Health Insurance Act into force for the implementation of the NHI.

We call on President Ramaphosa not to be swayed by unprincipled interventions of Business Unity South Africa [BUSA], who are fundamentally opposed to the NHI.

NEHAWU fully comprehends the need for Government to entertain perspectives on legislation from all sectors of society which is part of the President's political commitment to build a social compact between Government, Labour, Civil Society and Business.

Our concern over the most recent attempt to stall the implementation of NHI is foregrounded on the fact that the NHI Act went thorough series of debates, scrutiny and deliberations. During this process, Business had ample opportunity to raise their concerns and provide their perspective on viable alternatives for achieving Universal Health Coverage (UHC), which they claim to support. The contradiction lies in the timing of their unprincipled interventions, with a similar attempt to stall the passing of NHI through the National Council of Provinces in 2023, when BUSA appealed directly to the Deputy President to defer the Bill, delaying it for a week.

Another concern is the sway and influence Business has over government, it seems that the Presidency is at every beck and call to BUSA. NEHAWU is of the opinion that all social partners must be treated on an equal and democratic standing.

As NEHAWU, we reassert that any sustainable path to UHC requires a single-payer system. We remain confident that any proposal will fail without the establishment of a single-payer funding pool. Non-voluntary insurance models, like the NHI, ensure inclusivity by preventing discrimination based on health status, age, or income. This approach creates a safety net where healthier and wealthier individuals cross-subsidize those with greater healthcare needs, making access universal and equitable for all. This is the root of concern raised by Business, as the implementation of NHI will see the billions of Rands serving the interests of a small portion of the population equalised to serve the majority.

The current voluntary and fragmented system entrenches inequality, leaving millions without proper coverage. Experience from international models has shown that voluntary insurance leads to exclusion and inefficiency, as risk is not evenly distributed, and market-driven incentives being the dominant motivation. Only through a single, pooled fund with a single purchaser can we ensure cross-subsidization and equitable access, while controlling costs and avoiding fragmentation.

NEHAWU therefore urges the President to ensure that the tireless negotiations and consensus met through NEDLAC processes and Legislative debates are not unbundled by BUSA's constant backdoor interventions. We urge Business to act in good-faith and caution their clear attempt at undermining social compacting in which we have all committed to, threatening the very stability of the Seventh Administration.

Lastly, Universal Health Coverage cannot be achieved without a centralized funding mechanism; any system that relies on private insurance or voluntary contributions will continue to marginalize vulnerable groups, leaving our country's vast health disparities unaddressed.

END

Issued by NEHAWU Secretariat.

Zola Saphetha (General Secretary) at 082 558 5968; December Mavuso (Deputy General Secretary) at 082 558 5969; Lwazi Nkolonzi (NEHAWU National Spokesperson) at 081 558 2335 or email: [email protected]

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