NHI Hits A Major Roadblock As Legal Battles Stall South Africa’s Healthcare Future

South Africa’s long-awaited National Health Insurance was meant to be the big turning point, a chance to finally create a fair and universal system that works for everyone. Instead, it has hit a wall at the very moment the country needs solutions the most.

Profmed chief executive Craig Comrie describes the situation as an intensifying healthcare paradox. On the one hand, universal healthcare remains a shared dream across political lines. On the other, the NHI as currently designed is trapped in legal battles that could take years to resolve.

A Vision Without A Clear Path

Comrie argues that the idea of NHI is not the issue. The problem is the gap between ambition and feasibility. South Africa’s economy is simply too weak to sustain the current funding model. With a shrinking tax base and sluggish growth well below the 5 percent level needed for fiscal breathing room, the NHI has become a plan without a realistic implementation timeline.

The Department of Health insists the NHI Act is already law. Yet multiple organisations representing doctors, hospitals, medical schemes and unions want the legislation reworked from the ground up. Finance Minister Enoch Godongwana suggested an out-of-court settlement to speed things up, but neither side is willing to budge.

For now, the courts will decide how far the NHI can go. That process might stretch into the next few election cycles, making the NHI more of a political talking point than an actionable healthcare reform.

When Legal Disputes Delay Real Problems

Behind all the noise sits the deeper issue that South Africans experience every day. Healthcare is becoming increasingly unaffordable, whether you are on a medical aid or dependent on the state.

Healthcare costs rise faster than the normal inflation rate globally, and South Africa is no exception. Advancing technologies, limited specialist numbers and growing patient demand keep pushing prices up.

South Africa has too few general practitioners and specialists per capita. Many doctors who want to work cannot find posts. Others in the profession are nearing retirement with too few younger clinicians replacing them. It creates a long-term supply crunch that worsens both public and private sector delays.

Even though only 15.5 percent of the population belonged to a medical aid in 2024, StatsSA found that another 25.3 percent still seek private doctors or clinics first. For many families without medical cover, that means borrowing money or selling assets just to receive care. It is a stark reminder that health affordability affects everyone, not only the insured.

The Missing Reform That Could Change Everything

Comrie believes South Africa already has a practical way to widen access, but it remains stuck in policy limbo. Low-cost benefit options in the medical aid sector could bring millions more into the private system. These options have been discussed for years yet never fully approved by authorities.

Because of this vacuum, cheaper but low-value health insurance products have stepped in. These offerings take premiums without providing the protection that proper medical schemes guarantee. It is a symptom of a system trying to patch itself rather than repair the foundation.

A Country Running Out Of Time

The central warning from Comrie is simple. While the NHI drags on through courts and political arguments, neither sector can afford to stand still. Public hospitals face overcrowding and staff shortages. Private healthcare is becoming too expensive for a growing number of households.

Real progress will depend on cooperation, pragmatic reforms and a willingness to make changes that are financially sustainable. NHI remains an important goal, but the country needs solutions that start helping people now.

If the healthcare system continues to wait for the NHI to be fully resolved, the crisis may deepen long before the promised improvements arrive.

{Source:Business Tech}

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