Although South Africa’s system is among the best in the region, the percentage of individuals covered by a medical aid scheme barely changed between 2002 and 2022. Over the period studied, it rose from 15.9% to 16.1%, with over 70% of households using public health facilities, according to the government. To make healthcare more accessible, South African President Cyril Ramaphosa announced on 14 February 2024 his decision to sign the National Health Insurance (NHI) Bill.
South African President Cyril Ramaphosa on 14 February 2024, announced his decision to sign the National Health Insurance (NHI) Bill into law. The enactment of this bill will make it possible to provide universal health cover for South Africans. This decision was announced at a time when the percentage of people covered by a medical aid scheme was 16.7% in 2022.
« The fact that we need to move towards universal health coverage is an obvious measure that needs no debate. It’s a resolution that was taken last year and South Africa is one of the countries that has signed up to this commitment ».
Kathledo Mothudi, Chief Executive Officer of the Council of Health Funding Agencies – South Africa
Initially tabled in August 2019, the Health Insurance Bill was passed on 12 June 2023 in the National Assembly in South Africa. The bill, according to the South African authorities, aims to provide healthcare to millions of its poorest citizens as part of a major overhaul of a two-tier system that still reflects deep racial and social inequalities three decades after the end of white minority rule. However, business groups are strongly opposed, claiming that it would lead to disinvestment in the health sector and damage South Africa’s already fragile economy.
« We are aware of the constraints experienced by the private sector, but also of the availability of medical staff and medical facilities, which are much more evident in the private sector ».
Kathledo Mothudi, Chief Executive Officer of the Council of Health Funding Agencies – South Africa
This announcement comes at a time when South Africa’s healthcare system faces disparities between the access and quality of care provided by the public and private sectors. According to International Citizen Insurance, 80% of doctors work in the private system, neglecting the public system, which is constantly short of resources. With this decision, the South African president hopes that, by 2030, the country will guarantee access to good quality healthcare services provided by the public and private sectors to all citizens and residents of the country, regardless of their socio-economic status.