News Africa14 Apr 2025

South Africa:Private healthcare providers will have a role in national health insurance scheme, per Treasury official

| 14 Apr 2025

Private sector healthcare funds will have a role to play in the government-backed National Health Insurance (NHI) scheme because the government cannot finance the system on its own, according to the chief director of health and social development at the Treasury, Mr Mark Blecher.

The possibility of the NHI squeezing out private operators “is very unlikely for a very long time, if at all”, reported the weekly newspaper Mail & Guardian, quoting Mr Blecher.

It’s not easy to raise taxes and the role of private financing is very important in our context, and it’s very difficult for government to take on that private financing, so … we’re going to continue to see a role for private medical schemes and a multi-scheme arrangement for many many years,” he told a recent roundtable discussion on NHI. 

He was addressing fears raised by players in the private healthcare sector that they would be barred from being part of NHI.

According to a statement posted on the website of the National Department of Health, the NHI is South Africa’s strategy to achieve universal health coverage. The NHI is a centralised, national insurance fund from which the government will buy healthcare services from healthcare providers in both the public and private sectors. All eligible South African residents, as defined in the NHI Act, will be able to visit these providers whenever they need healthcare, without any payment. The NHI will be funded by taxes and special contributions, in line with what each person can afford.

The NHI Bill was signed into law on 15 May 2024. The government is phasing in the implementation of the NHI from 2024 to 2028. 

Mr Blecher also said, “The inclusion of private services as providers [under the NHI] is going to move very gradually … It’s going to be a very gradual development and the first few years is very much trying to set up the public purchasing capacity, even for the public services.” 

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