Non-profit civil rights organisation Solidarity noted on Tuesday that South Africa does not have the necessary financial resources to support the proposed National Health Insurance (NHI), which it predicts will lead to a further reduction of quality healthcare services in the country.

Solidarity Research Centre economic researcher Theuns du Buisson expressed scepticism about the latest promises made by President Cyril Ramaphosa regarding the NHI, explaining that the reality of the healthcare system in South Africa was vastly different from the picture painted by the President.

Du Buisson said Ramaphosa’s statement that the NHI would put an end to the “apartheid that prevails in the health care sector” is a deliberate disregard of certain key facts about the system.

He said it was important to acknowledge the origins of the existing infrastructure of large hospitals in South Africa, which he said mainly had been built before the African National Congress (ANC) came to power.

“Since the ANC came to power, almost no attention has been paid to the maintenance of State hospitals. Only private hospitals have been built by the private sector,” he said.

He noted the success of private hospitals, which he said proved that the private sector could function efficiently and independently.

He explained that this was a clear indication that the NHI would not work and that functioning health services were dependent on private management.

He blamed the ANC government for failures in the healthcare sector.

“This government has let the public health sector fall into disrepair. They have introduced policies that increase unemployment. They have introduced policies that prevent medical aid schemes from offering affordable options. To expect that they will be able to roll out the NHI in a good way is insane,” said Du Buisson.

He added that the accusation that there was apartheid in the current healthcare system no longer applied, he claimed, as the majority of medical aid memberships in South Africa were taken out by black people.

“This membership actually reflects the demographics of the labour market as a result of free choice and not as a result of any conspiracy, as Ramaphosa implies. It is clear that the ANC government is the primary reason for the current state of the healthcare system,” he explained.

A 2023 Statista report showed that when comparing membership rates by population group, coverage by medical schemes was noticeably higher amongst white individuals (at 71.9%), than Indians/Asians (at 48.7%), coloureds (at 18.2%) and Black Africans (at 9.7%).

Meanwhile, Du Buisson said the ANC had not only allowed the deterioration of the public sector, it had also implemented policies that “promote unemployment” in the public service and prevent medical aid schemes from offering affordable options.

“Therefore, to have expectations that this government will be able to successfully roll out the NHI is totally unrealistic. Even if the ANC could establish a workable healthcare system under the NHI, it is unlikely to be successful, as doctors do not want to work for the State,” he said.