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By Martin Williams

Councillor at City


Be on the alert for NHI in budget speech

President Cyril Ramaphosa needs to pocket his pen before he signs the controversial National Health Insurance Bill.


For SA’s abused middle class, a big issue in today’s budget speech will be the National Health Insurance (NHI). Will Finance Minister Enoch Godongwana announce feasible NHI funding?

As a country, as families and as individuals, we cannot afford this pipe dream, which threatens to ruin one of SA’s last remaining functional sectors – private health.

Even Discovery chief executive Adrian Gore, one of SA’s most unfailingly optimistic corporate leaders, has sounded warnings.

President Cyril Ramaphosa, during his State of the Nation Address, thought he was being funny when he mockingly repeated, “I’m looking for a pen.” There were giggles and cheers from economically illiterate MPs.

Ramaphosa knows that when he uses that pen to sign the NHI Bill into law, massive changes will be introduced in health care – the same dumbing down which cadres inflict on whatever they touch.

ALSO READ: NHI Bill may spell ‘health shedding’

Given the ANC’s track record in every sector, including health, we have reason to expect the worst – fatal consequences included.

Think, for example, of the 144 mental health care patients who died and the 1 418 others who were subjected to torture, trauma, and poor health outcomes in the Life Esidimeni tragedy.

Mini-Esidimenis are still happening.

There is no evidence of a clean-up, or any serious consequences for the culprits. Having spawned an uncaring health system, the ANC wants to inflict the same upon all of us, regardless of payments we might want to make to ensure reasonable standards.

If Godongwana today signals the advent of NHI, there will inevitably be a further shrinking of the already dwindling number of taxpayers. If you won’t allow people to pay for better health care, they will leave. And those left behind will be worse off.

ALSO READ: Doctors cite the NHI’s dangers

Gore told Business Times that, based on calculations by economists, there are several ways the additional R200 billion needed annually to fund the NHI could be raised.

These include a 31% increase in personal income tax and raising VAT to 21.5%.

“Against the backdrop of an extremely narrow and stretched tax base of about 5.2-million registered taxpayers, as well as high unemployment, none of these proposed tax approaches is realistic or achievable.

“We do not believe that increasing the tax burden on a narrow tax base is sustainable,” he said.

Yet, because this is an election year, Godongwana will be under pressure to announce measures that will appeal to the greatest number of potential voters, regardless of their contributions via taxes or any form of economic activity.

ALSO READ: ‘I am looking for a pen’- What Ramaphosa said about the NHI at Sona

Politicians worldwide love spending other people’s money.

In this respect, the ANC are no different from counterparts elsewhere.

But when they treat income producers with deliberate disdain, while courting others to become increasingly dependent on the state, a line is crossed.

With debt levels already unsustainably high, Godongwana may be persuaded to dip into the R500 billion available in the Gold and Foreign Exchange Contingency Reserve Account (GFECRA).

This would be like selling off family assets and leaving nothing for the proverbial rainy day. If Godongwana dips into GFECRA while launching NHI, he will be consigning the SA economy to an intensive care unit.

An NHI go-ahead could kill our ailing economy.