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ActionSA notes with concern recent media reports quoting senior ANC sources saying that the ANC plans to table a compromise proposal at the first Cabinet lekgotla of 2025. This proposal would apparently force all South Africans in the formal sector to obtain medical aid and establish state competition with private medical schemes by offering cheaper options through National Health Insurance (NHI). 

While these reports have been dismissed by the Minister of Health, the underlying issue remains clear: the ANC’s policy uncertainty is the only thing more detrimental to South Africans than the NHI itself. Policy uncertainty remains the hallmark of the government of national unity (GNU) so far.

ActionSA calls on the Minister to halt the implementation of the NHI entirely and instead focus on addressing the systemic failures of South Africa’s healthcare system. The government must prioritise reforms to the current medical aid regime to ensure equitable and affordable healthcare access for all South Africans.

The findings of the comprehensive Health Market Inquiry (HMI), chaired by retired Chief Justice Sandile Ngcobo, provide a sound basis for reforming the healthcare sector. After six years of meticulous investigation, the HMI identified systemic issues in the medical aid and healthcare market, including a lack of competition, cost inefficiencies, and opaque pricing structures. There can't be two insurance systems, one for the rich and one for the poor. We need a comprehensive system for all South Africans.

ActionSA urges the government to implement the inquiry's recommendations, such as strengthening regulatory oversight, fostering price transparency, and reducing barriers to entry for smaller players in the healthcare market. These reforms would improve access to affordable healthcare without adding layers of bureaucracy or opening the door to corruption.

While the NHI is ostensibly well-intentioned in seeking to address healthcare inequality, its current structure is fundamentally flawed. Instead of resolving the disparities in the healthcare system and fixing public health facilities and services the NHI introduces a third-tier system that duplicates inefficiencies and creates fertile ground for corruption—precisely as witnessed during the Covid-19 pandemic, where billions of rands were lost to PPE-related graft. This ill-conceived proposal threatens to collapse South Africa’s healthcare system entirely.

ActionSA has long argued against the glaring hypocrisy of Parliamentarians and Cabinet members who enjoy exclusive access to private healthcare at the taxpayer’s expense while ordinary South Africans suffer under the burden of a decaying public healthcare system. If the government truly seeks to uplift the nation’s healthcare system, it must demonstrate accountability and embrace reforms rooted in transparency, efficiency, and the best interests of all South Africans.

Issued by ActionSA Member of Parliament Dr Kgosi Lettlape