Health Minister, Dr Aaron Motsoaledi, has emphasised the department's commitment to forge ahead with implementing the National Health Insurance (NHI) in phases in his Budget Vote Speech.
"We will have to start implementing NHI in phases, as we are already in phase 2. The rest of the building blocks of health will easily fall into place," Motsoaledi said on Thursday.
Tabling the Budget Vote for the 2024/25 financial year in Parliament, the Minister announced that the department had been allocated R62 218 899, a 3.5% increase from the previous year's R60.1 billion.
He informed Parliament that his priorities for the next five years consist of six building blocks outlined by the World Health Organisation (WHO). These include leadership, governance, access to essential medicine, the health workforce, health systems financing, information systems, and service delivery.
"Five of the six building blocks seem acceptable to everybody and debates around them are straightforward and clear. But one of them has generated a lot of heat and sometimes fury in some quarters. This is the health systems financing. In our country we have decided to call this NHI," he said.
The Minister said some believe that the country is not ready for the NHI, while others are of the view that it is "very expensive" and the country has no money for it.
"NHI is a health financing system, called Universal Health Coverage (UHC) by the WHO. It is a health financing system, which is meant to be an equaliser between the rich and the poor."
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Motsoaledi told the Parliamentarians that it was no debate that South Africa is the most unequal society in the whole world.
"If you want to see what inequality means, come to the health sector in South Africa. Within the borders of the same country, some are getting world-class healthcare, while others get such poor healthcare you may believe we live in different countries."
However, he said the country can no longer sustain such "gross inequality" and South Africa has been seeking a solution for the past 96 years.
The Minister referenced the WHO, which states that a country should allocate at least 5% of its Gross Domestic Product (GDP) to health to have a good healthcare system for everyone.
"This is not 5% of the budget of a country, it is the GDP, the total health of a country. In South Africa, we have far surpassed that recommended 5%. We are at 8.5%. European countries are at 9%."
This means South Africa's health system was supposed to be as advanced as countries in Europe, Motsoaledi explained.
"As is evident that is not the case. The question is why? But the fact remains that 51% of it goes to serve only 14% of the population and the nearly meagre 49% goes to serve a whopping 86% of the population."
He told the Chairperson that this needs to "stop now" and while there is support for the NHI, there are those who do not support it in its current form.
"Fair enough, but we cannot throw the baby away with the bathwater. Let us discuss which areas need to be ironed out but let us now be obstacles to what poor people have been waiting for close to a century," he added.
