NHI Bill Remains Controversial While President Promises National Dialogue

NHI Bill Remains Controversial While President Promises National Dialogue

President Cyril Ramaphosa has yet to sign the National Health Insurance (NHI) Bill into law. The bill is not with out controversy and some say that the bill creates its own complications. The president was speaking to Cosatu members at the union federation’s Worker’s Day Rally this week, he said that the ANC government had processed many policies and laws which were demanded by the country’s working class. Among these is the NHI Bill, which Ramaphosa says the nation owes it to the workers for advocating over the years. “You advocated for years, for you wanted all our people to be treated equally when it comes to health care,” he said. The president went on to say he was approached by Cosatu leadership, who told him, “If you don’t yet have a pen, Cosatu has a pen, and we are going to give it to you today so you can sign this law into operation.”   

President Ramaphosa is deliberately delaying signing the NHI Bill to gain traction for more votes. He wants to sign the bill before the end of his term and the general elections. Ramaphosa is holding his cards close to his chest over a Bill that many have commented has inconsistencies and may do more harm than good to the medical system. It is true that it was the Congress of South African Trade Unions (COSATU) that brought the matter of having equal health care to the attention of the African National Congress’ leadership. However, the president himself could be reluctant to enforce the law that was drafted due to its negative aspects that could encompass not just affordable health care but also scientific progress. This is what the private sector has argued warning that the bill itself could do more harm than good. If Ramaphosa signs the bill it could reflect badly on his presidency and legacy, if he doesn’t the same reflection will be cast.

 Given the repeated promises, it is becoming increasingly likely that the president will sign the NHI Bill into law before the election. However, this will go against advice and urging from legal experts, business groups, the private healthcare industry and even worker unions to delay it. The Public Servants Association (PSA) – which represents 235,000 members of the public service – became the latest group to call the president to ice the bill until funding mechanisms for the scheme could be ironed out. The bill, as it currently stands, does not lay out any funding processes for the R200 billion-plus NHI, except to say that it will be done through budget reprioritisation and various taxes sometimes in the future, as determined by the Treasury.

The NHI Bill is largely unpopular among those experienced in the healthcare system. It could end up doing more harm than good in its current form. President Ramaphosa is a businessman who has studied law himself and was one of the leading framers of the constitution. He should know through and through whether this bill will be able to stand on its own in the Constitutional Court. If he signs the Bill in law and it is struck down by the Court in Bloemfontein it would be hugely embarrassing. The Bill should be sent back to the National Council of Provinces and the National Assembly to be revised or scrapped in its entirety. A new bill should be redrafted. However, another matter could be where the President’s loyalties lie. The ANC or the constitution.

Following the elections President Cyril Ramaphosa says he wants to work with former president Thabo Mbeki after the elections to convene a national dialogue to address “enormous challenges” faced by South Africans and come up with solutions. President Ramaphosa said he supported the former stateman’s proposal for a national dialogue. Ramaphosa was speaking on the side lines of the Cosatu national workers’ day rally at Athlone Stadium in Cape Town on Wednesday. “We need to continue consolidating the consensus process that brings every one together. Working together with people like him [Mbeki] and others to bring that process of getting people to talk. What will we be talking about? The economy and how we can have an economy that is going to produce jobs. How we can embark on efforts to rid our country of poverty. Calling for a dialogue fits in very well, I support the proposal,” he said.       

That national dialogue Ramaphosa and Mbeki both desire could be determined by the make up of the new parliament that comes into office. If the ANC does not win an outright majority, then it can end up being in a coalition with other minor parties like the Democratic Alliance, the Economic Freedom Fighters or even Mmusi Maimane’s Build One South Africa. These other parties may even call for Ramaphosa’s resignation. It is unclear if they will settle for Deputy President Paul Mashatile to full his shoes. A National Dialogue will include major stake holders such as Civil Society, the Unions, major Corporations, the relevant political parties etc. If it takes place after the elections it will depend on who ever occupies the Union Buildings next. The dialogue’s main focus will be on job creation, tourism has been on the decline since Covid. In order for there to be job creation there needs to be economic growth.

The government needs to then ensure that the money flows to the right places. It is all a matter of time to determine the country’s future.

Article written by:

Yacoob Cassim

Journalist at Radio Al Ansaar