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Speaking at the 2024 State of the Nation Address, President Cyril Ramaphosa joked that he was “looking for a pen” to sign the National Health Insurance (NHI) Bill into law after it was recently passed through parliament.

The NHI aims to introduce universal healthcare, with the state acting as the single buyer of medical products for the population, eliminating all private healthcare outside of voluntary treatments. As good as this may sound – especially for the 1.5 million people in South Africa who are not on a medical scheme – those in the healthcare sector, including doctors, business leaders and even parliament’s own legal team, have been vehemently opposing the Bill.

The main question mark hangs over how the scheme will be funded, with fears that cash-strapped South Africans will have to pay more tax. It is also alarming (and ironic), given that the government has been unable to place just under 700 doctors amid financial struggles, despite the calls for greater funds to implement the NHI.

However, experts are saying that those covered by the private sector should not worry about the Bill – yet, anyway.

BusinessTech reported that Efficient Wealth said that Rampahosa and the ANC will use the NHI and other policies as electioneering tools. Even if it is signed into law (when Rampahosa finds a good enough pen), the current version will face an onslaught of legal fights, with the Bill not seeing the light of day for many years.

An interview between Gary Feldman, executive head of Healthcare Consulting at NMG Benefits, and Moneyweb‘s Jeremy Maggs also advises that nobody should cancel their medical aid quite yet as the NHI Bill is still way off.

Feldman suggested that the Bill is not going to impact the business models or the strategy of existing medical benefits companies anytime soon.

“If you look at once it’s been signed, there is still a lot of different legislation that needs to be adjusted as well, amongst others, the Medical Schemes Act needs to be changed and that only goes once the NHI Bill has been proclaimed. So that has to be changed and then in the interim…”

“We do believe that there are a number of societies, organisations like medical schemes, like Business for South Africa (B4SA), that will go to the Constitutional Court, challenging the constitutionality of the NHI Bill.”

He clarified that if and when this Bill is signed into law, it means the private medical scheme will not be able to offer the same benefits as NHI offers:

“So a medical scheme will only be able to offer top-up benefits. But, as I said, I don’t believe that that will happen for at least another seven to 10 years because the medical schemes bill clearly states as well that the medical scheme will not be able to offer that on full implementation.”

“Now we don’t even know what full implementation means because there is so much to clarify and to basically put in place before the NHI Bill will be implemented in full.”

So that’s why it has been advised for people to not cancel their medical aid scheme at the moment.

Come budget time at the end of this month, the Minister of Finance, Enoch Godongwana, is set to remove tax credits, which will have a huge impact on the middle-income sector of South Africa, Feldman noted.

We’re all just waiting to see where this goes.

[sources:moneyweb&businesstech]