Understanding the National Health Insurance Bill – Six articles to read

President Cyril Ramaphosa will sign the National Health Insurance (NHI) Bill into law on Wednesday, 15 May despite concern from opposition political parties and the private medical industry about its financial viability and impact on the healthcare system.

We've put together a list of six articles from our archive either written by, or after interviewing experts on the topic, that explain what the Bill is, how likely it is to achieve its goals and what the potential impact on South Africans will be.

1. National Health Insurance is a big fat empty promise – experts

New healthcare legislation is unimplementable, unaffordable, unclear and unlikely to happen any time soon, say the experts.

2. NHI – the problem with trying to kill two birds with one stone

Although those who work closely with the public health service naturally welcome the expected increase in public-sector funding, it is incorrect to assume that this will automatically improve badly run public hospitals, writes Dave Martin, co-founder of a rural health and education nonprofit in the Eastern Cape. If you throw more money at them, things might look somewhat better for a while, but it would be just hiding the truth of the failing system of management.

3. The NHI debate is throwing up misconceptions – here are the facts

The evidence suggests that the private sector is inefficient and unsustainable in the long run, while the National Health Insurance offers a cost-effective solution, writes Dr Olive Shisana, an honorary professor at the University of Cape Town and special adviser to President Cyril Ramaphosa.

4. The origins of opposition to the NHI Bill are rooted in the bigger problems of trust and competence

A legitimate concern about the proposed National Health Insurance is the almost complete lack of trust in the state-government-elite axis to manage effectively anything more than rinsing a tumbler. The rest is simply ideological and disingenuous, writes Opinionista Ismail Lagardien.

5. We are unlikely to be equitably able to access lifesaving, affordable medicines under NHI

All patients and the very sick should benefit from the best medicines and care science has to offer, not just the rich or the employed. At the same time, Universal Health Coverage should better public health outcomes. But this is exactly what the NHI Bill does not do, as currently drafted, writes Fatima Hassan, founder and director of the Health Justice Initiative, and a human rights lawyers and social justice activist.

6. There are paths to quality universal healthcare besides NHI

One of the most damaging aspects of our public discourse on National Health Insurance is the mistaken notion in some quarters that the only two options are NHI and the status quo, writes Marcus Low, editor of Spotlight. DM