COSATU applauds Parliament’s finalisation and adoption of the long delayed National Health Insurance Bill

06 December 2023

The Congress of South African Trade Unions (COSATU) applauds Parliament’s finalisation and adoption of the long delayed National Health Insurance (NHI) Bill.  The Federation is heartened that the National Council of Provinces (NCOP) stood up to the insatiable lobbying by business to delay today’s scheduled passage of the NHI Bill.  Pandering to the vested interests of private industry’s lust for profits at the expense of the health of millions of ordinary South Africans would mark a dark day in our democracy. 

The NHI Bill and policy mandate have been adopted by Cabinet, passed by both Houses of Parliament and received overwhelming support from thousands of workers attending public hearings on the NHI Bill over the past 4 years.  The Federation remains convinced that South Africa’s myriad of healthcare crises require the creation of a National Health Insurance (NHI). 

COSATU and the overwhelming majority of workers are in support of an NHI.  It is a government policy and market failure that 29 years into democracy most South Africans, in particular the working class, lack access to quality and affordable health care. This is not due to lack of resources but to their blatantly skewed distribution.  Government cannot continue to place the profit margins of private industry above the needs of society. South Africa spends 8.5% of its Gross Domestic Product on healthcare. This is higher than many industrialised and peer nations. However, half of this is spent on the 16% of society fortunate enough to have medical aid. The other half is spent on public health care for the 84% dependent upon the state. As a result, we have first class but under-utilised private health care available for 16% but charged at exorbitant prices and public health care overwhelmed with long queues, critical post vacancies, aging infrastructure and shortages and thus battling to provide basic health care for the 84% of society.

Consequently, many workers and their families are infected and dying from easily preventable and manageable diseases. Even workers fortunate enough to have medical aid, battle to afford to pay the ever-increasing medical tariffs. Most workers’ medical aids are depleted halfway through the year and are shamefully saddled with unaffordable co-payments.  They are often forced to forego necessary but unaffordable treatment.  The economy needs a healthy workforce if it is to meet its full potential.

The reality is that South Africa’s public and private health care systems are broken and unsustainable. It is critical that the NHI Bill be passed by the National Council of Provinces.  Government needs to move with speed to resource and build a quality NHI that will guarantee quality, accessible and affordable universal health coverage for all South Africans. Internationally the equivalents of an NHI in Scandinavia and elsewhere have worked well and provide positive models for South Africa.

We cannot afford to be a nation that 29 years after 1994 still grapples with the blatantly unequal and racially skewed distribution of resources and access to health care. The right to life and access to health care are inalienable constitutional rights. It is time that all South Africans are afforded these rights.  COSATU urges President Cyril Ramaphosa to assent to this long overdue, historic and progressive Bill that will change the lives of millions of destitute South Africans.

Issued by COSATU

For further information please contact:
Matthew Parks
Acting National Spokesperson & Parliamentary Coordinator
Cell: 082 785 0687