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SACP urges President Ramaphosa to stand firm on advancing the NHI, denounces profit-driven interference to undermine the law

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SACP urges President Ramaphosa to stand firm on advancing the NHI, denounces profit-driven interference to undermine the law

Image of Cyril Ramaphosa
President Cyril Ramaphosa

25th September 2024

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The South African Communist Party (SACP) denounces the influence of the selfish capitalist interests, apparently lobbying President Cyril Ramaphosa to stall the implementation of National Health Insurance (NHI). On 15 May 2024, President Ramaphosa signed the NHI Bill into law, marking a momentous shift to do away with the highly unequal two-tiered healthcare system in South Africa. 

President Ramaphosa and the government at large must remain steadfast in the imperative to take the NHI forward. We call on all progressive organisations and supporters of the NHI to join the SACP in defence of this much needed transformation of our healthcare system. Now is the time for decisive action.

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The unjust two-tier healthcare system is characterised by private monopoly-dominated healthcare provision catering for a minority of the population, between 14 per cent and 16 per cent, based on wealth, income and exorbitant access, on the one hand, and exclusion of the millions of the workers and poor who cannot afford, on the other hand. 

Private health insurance in South Africa claims a higher share of our country’s total health expenditures, 41.8 per cent (based on 2013 and 2015 data) than any country globally. That is equivalent to 3.7 per cent of our country’s Gross Domestic Product. In this unjust context, the public healthcare sector, which caters for the overwhelming majority of our population, at least 84 per cent, is under-funded, under-resourced, overcrowded and overwhelmed. This injustice must end through the NHI principles, including social solidarity, free access to healthcare at the point of service, universal access, the NHI Fund and capacitated public administration. 

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The National Health Insurance is not just a policy or legislation – it is an imperative to ensure access to quality healthcare for all: a constitutional right for all – not a privilege for a few.

After years of extensive public consultation across all sectors of society, the advance towards the NHI must finally become a reality through the law. When President Ramaphosa signed the Bill into law, he boldly declared that “NHI will be implemented, whether they like it or not”. As the SACP, we campaigned for and fully supported this direction.

Under NHI, healthcare will be publicly funded, ensuring that every South African receives care based on their needs, not their financial means. It is an imperative for dignity, equality and fairness, an advance towards our constitutional obligations and the Freedom Charter.

Those who oppose the NHI seek to preserve a system that benefits the minority at the expense of the majority, prioritising profit over people. Proposals put forward by groups like the Hospital Association of South Africa, Business Unity South Africa and others fall far short of the principles that the NHI stands for. Their proposals aim to protect private wealth accumulation interests instead of advancing access to quality healthcare for all. The NHI, by contrast, is rooted in the principle that healthcare is a shared public good, not a commodity, an article destined for sale to only those who can afford.

Implementing the NHI, like any paradigm shift, will not be without its own challenges. Vested interests, especially those who profit from maintaining inequalities in healthcare based on the unjust two-tiered system, will resist and attempt to delay or derail this process. 

The working class must not allow those who seek to protect profits over people to stand in the way of this historic and radical transformation, the NHI.


Issued by the South African Communist Party,

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