nhi bill democratic alliance

Photo: Supplied

DA: Five reasons why NHI would be disastrous for South Africa

Here’s the DA’s five reasons why the NHI Bill is not going to work in South Africa.

nhi bill democratic alliance

Photo: Supplied

With four days left to submit opinions on the National Health Insurance (NHI) Bill, the DA has, on Monday, handed in more than 87 000 public submissions to Parliament.

The solution to South Africa’s healthcare problems came in the form of the NHI Bill, which seeks to centralise the business function of aid, with government at the helm.

The DA, much like many detractors, has opposed the NHI Bill, since its inception. The official opposition party has labelled this as ‘a rushed political win’ on the part of the ANC and not feasible in our flailing economy. Hence, the DA, led by Chief Whip, Natasha Mazzone, hauled boxes of signed submissions which justify their 25 reasons why “the [NHI] Bill in its current form is deeply flawed and will not achieve quality healthcare for all.”

In a statement, the party quoted five overarching reasons and we will explore these below.

Five reasons why the DA opposes NHI

Poor governance structures

The DA has argued that the NHI is threatened by the mere fact that it will be established as a state-owned enterprise. There is also the issue of accountability. As prescribed in the Bill, the NHI Board will be appointed by the Minister of Health, which “opens the entire process to political manipulation without adequate checks and balances.”

“The failed NHI pilot projects which were rolled out across the country at a R5 billion price tag failed spectacularly. They demonstrated the state’s incapacity to rolling out this massive and intricate model. Healthcare professionals who worked on the projects were never paid for their services and yet the state seeks to roll this out on a national scale, including the private sector too,” the DA noted.

Too many vague elements of the Bill which indicate poor planning

The DA has also raised concerns with the planning of the Bill’s roll-out and more concerning is the fact that there is still no clarity around the package of services that will be provided under an NHI environment, or what the role of medical aids and healthcare providers/funders will be.

“Furthermore, how complaints are dealt with in this system is vague. The referral pathway that consumers must follow is complicated, takes away choice and removed the autonomy of healthcare providers. The Bill [also] does not address the systemic failure of healthcare and the quality of the service being offered to people,” the statement read.

Funding of the Bill is in question

The question of who will fund the rollout of NHI is still unanswered. During the mid-term budget policy statement, Finance Minister, Tito Mboweni indicated that Treasury does not have sufficient funds to sustain the advent of NHI. So, where will the money come from?

“The DA has long held that the answer to quality healthcare is not a flawed funding model. It is a systemic overhaul of the system. Therefore the diagnosis of what is wrong with the health system is incorrect. South Africa could – in an optimal economic environment with strict accountability mechanisms – be able to roll out universal healthcare,” the DA added.


The Bill, according to the official opposition, also flouts Section 27 of the Constitution. The NHI Bill notes that emergency medical care will only be “provided for the asylum seekers and those who are in the country illegally.”

” This could then mean section 27 would have to be amended if we are deviating from it,” the DA noted.

Parliamentary public participation has been flawed

The DA also says that the public hearings on the Bill have been hijacked by dirty politics. Several cases of misinformation have been reported to the Chair of Chairs, Cedrick Frolick, after it was found that fraudulent leaflets spreading misinformation and misleading the public were distributed.

“They (supporters of the Bill) have been misled – as is clear from their submissions – that this Bill will fix what is broken with the health system. It will not. While he DA respects the views of all South Africans whether they support or reject the Bill, what we have heard are the views of people who have been let down by a health system for 25 years, the DA exclaimed.

The party handed over the 87 000+ public submissions as a means of making the people’s voices heard.

“We will ensure that no submission is over-looked and that the portfolio Committee considers each and every submission made,” the party said.