Solidarity welcomes the harsh and comprehensive criticism the acting Director General of the National Treasury, Ismail Momoniat, levelled at the controversial National Health Insurance Bill. This criticism came to light after a letter to the Department of Health was leaked. Morné Malan, a senior researcher at the Solidarity Research Institute (SRI) explains: “The version of the bill released for comment in June this year, has already been criticised from all quarters. It is encouraging that Treasury has now also joined the fray, smothering the flames of ideology by throwing cold water of reality on them”.
Treasury’s letter suggests that the bill, as amended in October, does not serve before cabinet before thorough consultation has taken place and extensive changes have been made to it as it currently reads. Treasury’s criticism relates to virtually every single aspect of the draft legislation. Malan lists the following points of criticism:
From a legal point of view
- According to Momoniat the proposed legislation is unconstitutional.
- Moreover, the bill seeks to trump many other pieces of legislation, including for example the Public Finance Management Act, the Division of Revenue Act, the Intergovernmental Fiscal Relations Act, and the Competitions Act.
- It is clear that the Department of Health has unilaterally changed the bill and did not pay heed to any of the written submissions lodged.
From an economic point of view
- The Department of Health did not put figures to the cost of the fund, the provision of national health care as such or any other related matters such as the establishment of clinics and the creation of authorities.
From a practical point of view
- As its predecessor was the bill is incoherent, unclear, ambiguous and unworkable. The interaction between the various departments, how funding would function, the responsibilities and location of health service providers all remain unclear.
From a socio-political point of view
- The proposal that in future all private medical aid schemes and funds should only provide complimentary services, creates uncertainty, and according to the letter it also displays an extremely threatening attitude towards all consumers of medical aid schemes, tax payers and anyone who might have wanted to invest in private medical care.
“It is almost as if Minister Motsoaledi considers this bill to be a piece of superhero legislation that trumps all existing laws, including the Constitution!
“With regard to its financing, even Steinhoff’s financials made more sense. It will involve huge expenses and not the faintest idea on how it will be financed, with Minister Motsoaledi still offering uncertainty and wishful thinking as a funding model.”
Solidarity is greatly encouraged by the Treasury’s pragmatic approach towards the NHI and demands the co-operation of the Health Department in this regard. Malan concluded, “This letter is a major blow against the ideologically drive approach followed by the Health Department up to now. The threat to health care providers, and the population as a whole, posed by the current format of the proposed NHI, is real. A letter such as this creates hope that islands of reason still exist within the ruling party, where practical and economically responsible considerations still hold weight. This letter is a very positive development for all who expressed their concerns about the proposal. In this boxing match it is encouraging to the South African public to be able to look back and see the Treasury in their corner.”