Blog
The NHI Act
A Framework Fraught with Challenges
André Jacobs
The National Health Insurance (NHI) Act, recently signed into law, has been the subject of much debate and scrutiny. As noted by constitutional law expert Pierre de Vos in his blog “Constitutionally Speaking,” the NHI Act is primarily a framework piece of legislation. This means it sets out broad principles without detailed enabling clauses, leading to significant regulatory uncertainty. This uncertainty is particularly concerning regarding aspects such as funding, defined benefits, and implementation timelines.
Publishing an Act to fulfil a promise of a transformed healthcare system, while the NHI Act remains largely undefined, does little to advance the cause. This framework has numerous unresolved issues that were overlooked during the legislative process, serving no immediate practical purpose. The Act’s current state implies that it will need to be amended either through lengthy negotiations or by instructions from the Constitutional Court, which could lead to unnecessary delays.
As highlighted by Pierre de Vos, it is inevitable that the constitutionality of the NHI Act will be challenged in court. However, he argues that the Constitutional Court is not the appropriate body to resolve policy disagreements about the NHI Act. The Court’s role is to review the legality of laws, not to decide whether a policy choice is good or bad. This is a vital distinction as the objectives of the NHI, which aim to eradicate existing healthcare inequalities, cannot be faulted.
The Act proposes the establishment of a National Health Insurance Fund to pay for a list of prescribed medical services. These services will be provided by registered healthcare professionals in both public and private sectors, with reimbursement rates set annually by the Fund. The full implementation of the NHI system could take 10 to 15 years, during which private medical schemes will be limited to covering services not included in the NHI Fund.
The concerns surrounding the NHI Act are valid, especially regarding its funding and implementation by a government with a history of inefficiency and corruption. Yet, as de Vos argues, the Constitutional Court should not be the venue for addressing these concerns. The NHI Act represents specific policy choices made by the democratically elected government. If the electorate disagrees with these choices, the solution lies in the political arena, not the judiciary.
A recent Sunday Times article reported that the Presidency now seeks to engage with business leaders regarding the implementation of the NHI. This move indicates an acknowledgment of the complexities and challenges that lie ahead. Constructive engagement with all stakeholders is crucial to refining the Act and ensuring its successful implementation.
As we navigate the implementation of the NHI, it’s important to remember that the Court’s role is limited to ensuring that laws do not breach constitutional rights. It is not to overturn policy decisions made by elected representatives. The NHI Act, in its current form, is a step towards realizing the constitutional right to healthcare, but it is just the beginning of a long journey.
Join Us for NHI Insight: Facts Over Fear
To gain a deeper understanding of what the NHI Act means for you, join us at our upcoming seminars. These sessions will provide a comprehensive overview of the NHI, dispel myths, and offer honest facts. Choose from online, in-person, or hybrid formats. Secure your spot today!
- NHIletsmakeadifference
- Universalhealthcare
- NHI
- NHImakeitwork
- nhiinsight
- nhifactsoverfear