The National Health Insurance( NHI) Bill is once again making headlines following a recent ruling by the Gauteng High Court. The judgment has added fresh momentum to the ongoing debate around the NHI’ s feasibility, constitutionality and potential impact on both the public and private healthcare sectors.
A recap of the NHI
The NHI is South Africa’ s plan to provide universal healthcare to all citizens and legal residents, regardless of their income or employment status.
Its key role is to create a single public health fund that pays for essential healthcare services, aiming to ensure equal access to quality care for everyone, while reducing reliance on private medical aid and out-of-pocket payments.
Latest news
In a recent development, the Gauteng High Court has ruled that President Ramaphosa must provide a full record of his decision to sign the NHI Act into law, opening the door for constitutional challenges and potentially delaying the 2024 – 2028 rollout.
This ruling comes in response to legal challenges from the Board of Healthcare Funders( BHF) and the South African Private Practitioners Forum( SAPPF), who argue that the President failed to consider substantial constitutional and financial objections raised during the legislative process.
Financial concerns
Experts estimate that implementing the NHI could cost between R900 billion and R1.3 trillion, far exceeding the government’ s projections. Critics also argue that the current economic climate makes such funding unfeasible.
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Bonitas Member Magazine Issue 2 / 2025
Despite the NHI’ s goal to centralise healthcare funding, the National Treasury has reassured stakeholders that private medical schemes will continue to play a role for the foreseeable future, acknowledging that the government cannot finance the system on its own.
Collaboration is key
We have always been supportive of access to universal healthcare. However, we strongly believe public and private healthcare systems have a dual responsibility to deliver this. We acknowledge the gap that exists, especially in terms of infrastructure and believe we have a role to play in supporting the enhancement of public facilities and healthcare reform in general.
In fact, we have supported various public healthcare initiatives over the past years in partnership with Gift of the Givers. These have included providing access to water infrastructure to supply clean, running water at various public health facilities, hospital ward refurbishments, supplying medical bursaries and sponsoring an audiology programme, to name a few.
The way forward
The NHI remains a topic of national debate, with ongoing discussions around its feasibility, funding and the implications for both the public and private healthcare sectors. For now, we reaffirm our position: It’ s business as usual. Bonitas remains committed to exploring ways to ensure our members continue to receive access to affordable, quality healthcare – just as we have for more than 40 years.