16 February 2022

SACP expresses support for NHI Bill, reiterates its call for South Africa to advance towards NHI to ensure access to quality healthcare for all and equality in healthcare

In its presentation to the Parliamentary Health Portfolio Committee on Tuesday, 15 February 2022, the South African Communist Party (SACP) reiterated its call for South Africa to advance towards a National Health Insurance (NHI) to ensure access to quality healthcare for all and equality in healthcare. The SACP stressed that the NHI was an imperative and expressed its support for the NHI Bill with proposals for its improvement.

The NHI Bill marks a decisive break with the unequal and irrational “two-tiered” health system, a system that reflects the persisting and worsening income and wealth inequality in our society. The NHI seeks to ensure not only access to quality healthcare for all but also the redistribution of existing healthcare resources to build equality in healthcare.

There is vast evidence showing that the commodification of healthcare cannot guarantee healthcare for all. By placing people before profit, the NHI underlines the necessity to decommodify healthcare. In societies where healthcare is sold like any other commodity to facilitate private wealth accumulation, only a tiny minority, largely the capitalist class and the well-off, enjoys the right to life in terms of healthcare security, while the majority, chiefly the working-class and poor, comprises among others the majority of those who die of preventable and curable diseases.

Our hard-won right to life is entrenched in our constitution. The healthcare system must reflect this value and support the fundamental right to life. Anchored in universal healthcare and social solidarity, with a caring distribution of healthcare resources, as well as a disease prevention vision, properly articulated the NHI has a great role to play in ensuring that everyone has access to quality healthcare on the same terms, regardless of whether they have or do not have money to pay.

Due to its pro-people foundation, the NHI enjoys popular support. There is wide evidence that in countries where similar healthcare systems were introduced, the quality of life among their populations improved sharply.

The NHI Fund will need to focus on resourcing the public sector, which currently serves approximately 84 per cent of the population but has suffered from years of under-funding. This is one of the proposals that the SACP made for the NHI Bill to be improved.

Another proposal that the SACP made is that as the backbone of the NHI, the NHI Fund will require significant resources to address historical spatial disparities between and within provinces.

Yet another proposal the SACP made is that the NHI Fund must have inbuilt mechanisms to fight corruption to protect it from forces of corporate-capture. Some of the forces that opposed the NHI will shift to manoeuvres to capture the NHI Fund or destroy the NHI. This must be dealt with in advance through the design of the NHI and its Fund.

The Bill correctly stresses the central role of the state in funding and organising a new universal health system. The SACP, however, rejects proposals for outsourcing this role of the fund to medical schemes administrators.

It is important to build a strong preventative approach as the entry point in respect of the comprehensive healthcare services that the Bill mentions and referral system. This requires investment in human resources and, to a great extent, infrastructure, equipment and medical research and development.

The working-class needs to unite and rally behind the NHI as well as all proposed improvements which aim to place the health needs of the people before profit.