South African lawmakers on Tuesday voted in favor of a controversial new law which aims to provide free universal healthcare, but which critics fear might not be sustainable.
A fund to be established under the law, which still has to be passed by the upper house of parliament, before being signed into law by South African President Cyril Ramaphosa, would provide healthcare for all at rates to be determined by the government.
After a heated debate the bill was adopted by 205 members of parliament and rejected by 125.
South African Minister of Health Joe Phaahla described the passing of the bill, which has been 12 years in the making, as a “historic milestone” and “one of the most revolutionary pieces of legislation” since the end of apartheid.
The National Health Insurance (NHI) would be “an equitable, accessible, affordable and strengthened healthcare system,” he said.
“As inequality has been growing in our country even cutting across race, access to quality health services has been a casualty with those who have private medical insurance consuming 51 percent of the national spending, while constituting only 16 percent of the population, while 84 percent depend on 49 percent resources from the fiscus and services provided” by public hospitals, he said.
If signed into law, it would “ensure all the people of South Africa have access to the same clinic or hospital [either public or private], closer to where they live or work without paying — government will pay,” the minister said after the adoption of the bill.
Everyone will contribute to the fund through taxes and special contributions.
Critics say the bill risks collapsing the health system.
South African Shadow Minister of Health Michele Clarke from the main opposition Democratic Alliance party rejected the bill as a ploy by the ruling African National Congress (ANC) party to canvas for votes ahead of next year’s crunch election.
“NHI will inevitably destroy all healthcare in South Africa,” Clarke said in parliament.
Busi Mavuso, CEO of Business Leadership South Africa, an independent forum representing some of the country’s largest business enterprises, said she feared the bill “would leave all South Africans worse off, in a system in which state provision becomes impossible and private health provision is effectively closed down.”
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