As the countrywide public hearings on the National Insurance Bill wrapped up this week with meetings in Gauteng, President Cyril Ramaphosa has dedicated his weekly letter to encouraging South Africans to mobilise behind the NHI and to ensure that it is implemented.

Calling the introduction of NHI one of the most far-reaching acts of social transformation this country has experienced since 1994, the President gave the assurance that South Africa has enough resources in this country to enable every man, woman and child to receive appropriate standardised quality healthcare.

Referring to the public hearings, he said the meetings have shown that there is broad support for fundamental change in our health care system.

“Participants have made a number of proposals and have spoken about their views on National Health Insurance (NHI), personal experiences of illness, trauma, disability and suffering – and the difficulties they have had in accessing healthcare when they need it, the President writes.

“It is these experiences that inform South Africa’s support for the global goal of universal health coverage. This goal has become a major aim for health reform in many countries and a priority objective of the World Health Organisation (WHO). It is instructive that WHO defines universal health coverage as a system that should ensure that all people have access to needed health services (including prevention, promotion, treatment, rehabilitation and palliation) of sufficient quality while ensuring that the use of these services does not expose the user to financial hardship.”

According to Ramaphosa, the country’s two-tiered healthcare system where a around R250 billion is spent annually on less than 20% of the population that can afford private care and R220 billion spent on rest of the population flies in the face of the constitutional right of access to healthcare for all citizens regardless of their socio-economic circumstances.

“It is a situation that cannot continue. It is inefficient and unsustainable. It is unfair and unjust. It is one of the greatest travesties of our time that access to decent and quality healthcare services is determined by one’s ability to pay, Ramaphosa stated.

“The key fundamental principles underpinning NHI are equity, solidarity, the acceptance and recognition of the equal worth of every individual, as well as the right of everyone to receive the medical care they need cost-effectively. This is something for which we must all fight.

“The escalating cost of healthcare is affecting South Africans from all social strata where it hurts most – in their pockets. As the report of the Health Market Inquiry published last year has shown, even those who have private health insurance are buckling under the pressure of rising premiums and shrinking benefits. Out-of-pocket payments are on the increase, draining disposable incomes and making it even harder for many to make ends meet.

“As a nation, a large share of our national expenditure goes to healthcare, yet there is a fundamental mismatch between what we spend and the health outcomes of our citizens. Just as we demand quality standards of healthcare for ourselves and our families, we should do the same for others. Just as we would not treat a relative or friend badly because they earn less than we do, we should care enough that they have equal access to treatment and care when they fall ill.”

Assuring South Africans that government will not be reckless in implementing the NHI and that it will be rolled out it in an incremental fashion to cover the whole country by 2025, the President called on the private sector to join government in seeing the NHI realized and to assist in making the  healthcare landscape more efficient and  cost-effective and value for money  by forging strong public-private partnerships for the delivery of services.

“We remain committed to ensuring there is effective consultation and engagement with all sector partners at all stages of the process,” the President concludes.