#Sona2025: The NHI takes shape: What’s at stake for medical aids?

Source: ChatGPT.

This follows the party's formal challenge to parts of the legislation just days before SONA2025, which could have led to the collapse of private medical insurance companies. Rather, both the ANC and the DA subsequently agreed to remove such provisions, and to lift their impasse.

This means medical aids look set to continue running in South Africa alongside the NHI.

This development marks a significant shift in the country's approach to universal healthcare, balancing the goals of the NHI with the preservation of private medical schemes.

Revitalising healthcare infrastructure

Speaking of the plans for the NHI, Ramaphosa said, "Our most immediate priority is to strengthen the health system and improve the quality of care. A vital part of this is the modernisation, improvement and maintenance of existing health facilities and construction of new hospitals and clinics."

He confirmed that a number of hospitals are under construction or undergoing revitalisation. These include the Limpopo Central Hospital and the Siloam District Hospital in Limpopo, the Dihlabeng Regional Hospital in Free State, the Bambisana District Hospital and Zithulele District Hospital in Eastern Cape, and the Bophelong Psychiatric Hospital in North West.

Other projects are at various stages of design and development, which includes the replacement of three existing old central hospitals, three new central hospitals, five new district hospitals, five community health centres and a new psychiatric hospital.

"We want a nation where quality health care is accessible to all," Ramaphosa said.

Ramaphosa emphasised the NHI's role in reducing healthcare inequalities by ensuring fair treatment for all. "The NHI will save many lives by providing a package of services, including maternal and newborn care, as well as provide support for people living with HIV, TB, and non-communicable diseases such as heart disease, cancer, and diabetes," he said.

Ramaphosa further noted that the groundwork is being laid for the implementation of the first phase of a single electronic health record and that preparatory work to establish Ministerial Advisory Committees on health technologies and healthcare benefits is underway. He said an accreditation framework for health service providers is also being created.

Reaching a compromise

Meanwhile, Planning, Monitoring, and Evaluation Minister Maropene Ramokgopa revealed that the ANC and DA reached a compromise just days before SONA2025 to address concerns about the future of private medical schemes under the NHI. According to reports, sections of the NHI Act that threaten the existence of medical aids, such as Section 33, could be amended.

DA leader John Steenhuisen verified that an agreement has been reached to remove provisions that could have led to the collapse of private medical insurance companies. The original NHI framework envisioned a single-payer system funded through taxation, potentially eliminating the need for private medical schemes.

As of now, specific details regarding the revised funding models have not been disclosed.

Furthermore, Steenhuisen added that the implementation of the National Health Insurance (NHI) has also been excluded from the medium-term development plan (MTDP). This indicated that there would be no budget allocation or implementation of the scheme for the next five years, he said.