Today, President Cyril Ramaphosa took a step to transform the healthcare system in South Africa by officially signing the National Health Insurance (NHI) Bill into law at the Union Buildings in Pretoria. The goal of the NHI Bill is to change the way healthcare is provided ensuring that everyone regardless of their status has access to necessary health services. However, not everyone is happy with the NHI, with some organisations threatening legal action.
Sparking many debates, some have applauded the signing as a progressive step that will transform the healthcare system and ensure equal access to quality care for all citizens, while others continue to voice their concerns about its implications and how it will be put into action.
During his address, Ramaphosa pointed out that the real challenge in implementing the NHI lies not in the lack of funds, but in the misallocation of resources that currently favours the private health sector at the expense of public health needs.
“The effective implementation of the NHI depends on the collective will of the South African people. We all need to embrace a future where healthcare is a shared national treasure, reflective of the dignity and value we accord to every South African life. The NHI is an opportunity to make a break with the inequality and inefficiency that has long characterised our approach to the health of the South African people,” he stated.

According to Ramaphosa, accessing healthcare by need, not by the ability to pay, will produce better health outcomes and potentially tackle poverty.
“The NHI is an important instrument to tackle poverty. The rising cost of healthcare makes families poorer. By contrast, healthcare provided through the NHI frees up resources in poor families for other essential needs,” he said.
“In signing this bill, we are signaling our determination to advance the constitutional right to access health care as articulated in Section 27 of the Constitution. The passage of the bill sets the foundation for ending a parallel inequitable health system where those without means are relegated to poor health care. Let us work together, in a spirit of cooperation and solidarity, to make the NHI work.”
Here are some articles published by Health For Mzansi to provide a better understanding of how the NHI might impact the lives of South Africans.
Explainer: How the NHI will impact South Africans
Long queues, not enough medical staff and resources, expensive medication… When it comes to healthcare, South Africa has a long way to go. The proposed National Health Insurance (NHI) has given hope to millions of South Africans as it aims to make quality healthcare accessible and affordable for everyone, regardless of their income or background.
In the midst of this enormous government-led plan being pushed ahead, there is some confusion about what it is and how it will impact ordinary South Africans’ lives.

NHI: The road to universal healthcare is full of potholes
A patient-centred health system will remain an illusion under the NHI unless the public health system is ramped up to better serve users and a clear path is outlined for public-private partnerships, argue Bernard Mutsago and Haseena Majid in this article.
Achieving a universal, affordable, high-quality, comprehensive, and patient-focused health system under the NHI will not be realised unless shortcomings of the public health system is fixed to meet the needs of the public.
NHI: Future doctors uncertain of the way forward
Imagine graduating from medical school and diving headfirst into a healthcare landscape that is completely transformed. While the full impact of South Africa’s proposed National Health Insurance (NHI) is still unfolding, medical students remain understandably curious about how the NHI will affect their future careers, considering both the challenges and opportunities it may present.

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