7 July 2021

Business Unity South Africa on National Health Insurance Bill (NHI)


Organised business and its members support the objectives of the NHI Bill as set out in the preamble. We support the overarching goal of universal access to quality healthcare services (in accordance with Section 27 of the Constitution) for all South Africans.


We are mindful that South Africa is one of the most unequal societies in the world and that health financing arrangements therefore must achieve a substantial redistribution of resources.


We recognise that access to healthcare and services is both a requirement for individual and family wellbeing, quality of life, and a determinant of productive livelihoods in local communities, places of work and the economy. As an active private sector representative body, we are supportive of policy changes that will stimulate productivity and economic growth in South Africa.


We made a submission to the Parliamentary Portfolio Committee on Health on 29th June 2021. The salient points of our submission were:


  • We commenced with an overview of BUSA, its members and position in support of universal healthcare coverage (UHC)
  • Analysis of the expected economic impact of the NHI Bill, especially given a weak and fiscally constrained macro-economic environment.
  • Unintended and detrimental consequences of section 33, which refers to the role of medical schemes. There is no rationale for section 33 and there are alternative ways of reaching this goal
  • Legal issues and potential challenges arising from the Bill
  • Evidence that shows that cross-subsidising by private providers of their income between the public and private sectors can achieve the same goals as a single public fund. This will ensure the sustainability of the healthcare system
  • The transition to NHI must be a phased approach and milestones must be defined.
  • Issues of governance must be addressed to ensure buy-in from all stakeholders.


BUSA’s submissions were based on extensive research by experts in the field. We reference the research throughout our submission.


Cas Coovadia

Business Unity SA CEO

Link to BUSA NHI Bill Fact Sheet: on the submission made to the Parliamentary Portfolio Committee on Health on 29th June 2021:

BUSA NHI Fact Sheet on the submission to the Parliamentary Portfolio Committee on Health on 29th June 2021

For more information, please contact:

Sizwe Maswanganye

Tel: 011 784 8000

Email: sizwe.maswanganye@busa.org.za

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