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A universal healthcare bill designed to provide quality health care for all in South Africa has sparked a heated debate in the country, setting up obstacles for its adoption by Parliament.

The National Health Insurance (NHI) bill, submitted by Health Minister Zweli Mkhize to Parliament last week, envisages a package of comprehensive health services for free at private and public health facilities as part of the government’s bid to provide more equitable access to quality health care.

A wide range of people will benefit from the bill, including inmates, refugees, permanent residents and all children in South Africa.

This will be done through the establishment of the NHI Fund.

Although the bill is at the point of being fiercely debated, the initiative has been allocated 2.11 billion rand (about 137 million U.S. dollars).

Critics say the financing model of this bill will mean the imposition of a new tax on ordinary South Africans who have already been squeezed dry by the government and cannot be subjected to yet another tax.

Several political parties and numerous bodies, including the South African Private Practitioners’ Forum, voiced scepticism about the bill, calling it unrealistic, too expensive, and would potentially damage the healthcare sector, particularly when the country is facing a financial crisis.

On Tuesday, the opposition Democratic Alliance (DA) sought urgent legal opinion on the constitutionality of the bill which it said would cripple the economy and health services in the country.

The party insists that the bill seeks to fundamentally alter healthcare policy in South Africa by creating a state-owned entity to consolidate all funds within the public and private health system.

This would result in billions of rand being placed in the hands of the politically connected, giving the health minister unvetted powers and in control of the entire health system, the DA argues.

Moreover, the bill completely centralizes the provision of healthcare by placing the management of all central hospitals under the national health department, which would utimately lead to the nationalization of healthcare and is a clear erosion of provincial powers, according to the party.

“This bill removes the autonomy of South Africans to choose their own health care. It mandates the national department of health as the sole provider of healthcare in the country while all private healthcare providers will be contracted by the state,” DA Shadow Health Minister Siviwe Gwarube said.

On Wednesday, Mkhize came forward in defense of the bill, describing it as a successful model for universial healthcare in the country.

Mkhize assured that the bill will not steer the healthcare sector in a financial crisis.

“The issue is not whether there is something wrong with the private sector. Both the public and private sector need to be realigned and that’s what we are doing. And it’s not like we are taking money from the one and giving it to the other,” he explained.

Mkhize accused the DA of seeking to maintain the status quo and protecting the privileged by opposing this bill.

The reality is that the country needs a much more equitable redistribution of the resources inside the same system, the minister added.

On Monday, the bill was forwarded to Parliament’s Portfolio Committee on Health for deliberation, part of a parliamentary process to pass a bill. The committee will hold nationwide public hearings before presenting the bill to the National Assembly for adoption.

Committee Chairperson Sibongiseni Dhlomo called the bill “one of the equalisers of society, where those who are poor can get access to good healthcare” and “a vehicle of making every citizen have access to healthcare.”

“It is a public good and addresses issues of social solidarity,” Dhlomo said.

The ruling African National Congress (ANC) Study Group on Health said it is pleased with the introduction of the bill.

For more than a decade, the ANC-led government has been advocating for the implementation of the NHI, based on the principle of universal health coverage, spokesperson Andile Mdleleni said.

“The NHI will bring about significant change to our society, not seen since the dawn of democracy in 1994,” he said.

Mdleleni refuted claims that the NHI bill would lead to nationalization of the health sector.

“Nowhere does the word ‘nationalisation’ appear in the bill; rather the bill makes it very clear that it will purchase services from both public and private providers,” Mdleleni said.

Private health care providers will continue to operate, as the NHI will not going to abolish or do away with private health providers, he added. Enditem

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