National Health Insurance Will Be Compulsory for All South Africans

While we’ve made some significant strides over the last couple of years, there are still a few things in life that we simply can’t opt out of. Joining that list, in the reviled company of death and taxes, will be our new National Health Insurance.

The NHI is designed to be one single compulsory medical scheme for all South African citizens and permanent residents. It is set to roll out in 2025.

Where does this place private healthcare plans, though? Their sustainability is still very much in question, with the government actively seeking funding for the NHI and not saying much about the future of private medical aid.

As the 2018 Budget Speech rolled around, most analysts expected the budget to chop medical aid tax credits. Nine million South Africans who are on some sort of medical aid gave a collective sigh of relief, as the tax credits were declared safe. For now.

The cost of monthly medical aid premiums are already high. To do away with these tax credits would see all of these people losing out on an annual tax rebate. In effect, medical aid would cost way, way more.

That’s about everything the average South African knows about the National Health Insurance at the moment. So, we thought we’d gather up as much info as we can.

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The Fate Of Private Medical Aid

The healthcare industry is one of the most important and active sectors in South Africa. Both private and public hospitals play a role in providing healthcare to the people. While the former may be well-funded, the latter is woefully not. This problem forms the cornerstones of the NHI initiative.

First, let’s take a look at the doom and gloom surrounding private medical aid.

Foremost, the government’s current plan for the NHI, and the ensuing restructuring of all medical aids, has alarmed some analysts. They believe that should this come to pass – and the government certainly seems hellbent on it – it could lead to people losing access to high-quality healthcare.

Last year, for example, private Mediclinic hospitals made up the majority of the top twenty hospitals in South Africa. Let’s compare these hospitals to the government-run Leratong or Baragwanath. What will become of high-quality healthcare, and will the NHI cause great, clean, safe hospitals to go the same way?

One matter overlooked in the 2018 Budget Speech is that even though people paying a fortune on medical aid will still be receiving their rebate, it will be capped at R310 per policy holder. This amounts to around a 2.3% increase in the receivable rebate.

In previous years, we’ve seen an increase of around 5% to 6% – while medical aid premiums saw an increase of between 7% and 10% for the year.

This saving will be used to cover some of our budget shortfall, as well as going toward other initiatives such as free education. So! Working-class South Africans who fork out for quality healthcare are getting nailed, either way…

But hey, at least the rebate wasn’t removed entirely. Enjoy your R310.

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National Health Insurance In Three Phases

It was recently announced that an additional amount of R4.2 billion has been allocated to the National Health Insurance. They have made room for this in our lovely national budget.

It was also confirmed that a special fund will be set up for refugees and that documented asylum seekers will have access to emergency care.

The NHI will be implemented in three phases.

First Phase – Prepare central hospitals to provide specialized services to all South Africans. This will be under the control of the central government.

Second Phase – Everybody who qualifies for the health insurance will be registered and issued with National Health Insurance cards.

Public hospitals, emergency medical services and the National Health Laboratory Services will be contracted to provide service.

Private Doctors and health-care providers will also be contracted to provide primary level services. This will be extended to healthcare providers who can assist to address ‘physical barriers to learning’ for school children. These include audiologists, speech therapists, psychologists and optometrists.

Priority in all cases will be given to those most vulnerable, such as mothers, small children and the elderly.

Third Phase – Mandatory payments will begin, made by working people, and private-sector providers will be contracted to provide service.


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