When will NHI be implemented once signed in law ?


Oct 19, 2023
HI Guys

I hear Cyril will sign in to law the NHI tomorrow, what does it mean for it's implementation?

You have to consider the legal tests that it still has to endure as well as the fact that there is insufficient funding for this.

Also, looking at the NHI bill, medical aids will only take a backseat once it has been fully implemented. Only then are they allowed to only offer elective treatments not covered by NHI.

So, it will take many years to implement if ever and probably never as proposed.
This ^^^
Smoker and mirrors and politicians being the scum they are

Yip, just before elections too. The bill will be thrown out by the courts before it ever gets implemented. This bill is so flawed it will never see the light of day. It's just last minute straw clutching by the ANC just before the elections;

The passage of the NHI Bill through the National Assembly and the National Council of Provinces (NCOP) was a complete farce, as any objections against NHI or even interrogations underpinning its reasoning were rejected outright by the ANC dominated health portfolio committees.

Even advice from the Parliamentary Legal Advisor that the NHI Bill is not constitutional was ignored. The ANC needs the NHI for these elections more than it ever has, and it is no coincidence that the NHI Bill was rammed through both houses of parliament last year.

When Ramaphosa puts pen to paper on Wednesday, the games will commence, as a slew of lawsuits are in the pipeline ready to outline the NHI’s many fatal flaws.

ANC just doing what terrorists do best - sabotaging the economy before they lose the elections
Heard one of the ministers say that government funds medical aid by about R46B per annum. What does this mean ?
It means they will start telling the voters they can start queueing at the private hospitals and practices and they are entitled to private healthcare, even though it hasn't been implemented yet.

It will hopefully die. If not it will be the death of the SA economy. The middle class will not stick around if there is no decent healthcare.

The government people in situations like this tend to leave the public hospitals for the masses while giving them and their families access to military hospitals which would be maintained at a much higher standard. Still, it is not gonna happen. However I am already hearing of more and more health professionals leaving due to the uncertainty. Essentially what this bill will do is make it so that you have to work for government if you are in the health sector, which is a terrible thing.
It means they will start telling the voters they can start queueing at the private hospitals and practices and they are entitled to private healthcare, even though it hasn't been implemented yet.

Can you imagine the EFF's noise? Probably some in the ANC too.
Email from discovery

I am reaching out following President Cyril Ramaphosa signing the National Health Insurance (NHI) Bill into law on Wednesday 15 May 2024. Though the NHI Bill is now an Act, there remains considerable debate and controversy on this front. I am writing to provide clarity and reassurance.

Upfront it is important to state that we unequivocally support universal health coverage and believe that a workable NHI is central to achieving this. However, in its current form, the NHI Act is not feasible as it rules out private sector collaboration. We remain strongly of this view and will continue to fight for an NHI that is viable and to the benefit of all South Africans.

At this stage, what do these developments mean for you?

Your medical scheme cover and benefits will not be affected for a long time to come

The central issue for medical scheme members like you is how the NHI affects you, your healthcare benefits and your access to healthcare. We have been asked questions such as “Does this mean the end of private healthcare?” and “When will my medical aid benefits cease to exist?”

In summary, people are concerned about the continuity of their cover in its current form. We understand this concern. It is based on a component of the Act - Section 33 - which is problematic. Section 33 states that once NHI is ‘fully implemented’ medical schemes will be able to cover only those services that are not covered by NHI. This implies that medical scheme cover will be replaced by the NHI at that point in time.

While this appears threatening, practically it isn’t. This, for two reasons.

First, the impact of Section 33 is that only once the NHI is ‘fully implemented’ will medical schemes be limited in the cover they provide to medical scheme members. Until this point, there will be no change to your medical scheme cover. We believe it will take a long time – a decade at least – to achieve ‘full implementation’ given the scale and complexity of reforms needed. Bear in mind the NHI is an inordinately large and complex initiative that proposes extraordinary change and restructure to public and private healthcare systems. This is unprecedented and will be incredibly difficult to achieve.

Second, even when the NHI is ‘fully implemented’, medical schemes will still be able to provide cover for benefits not covered by the NHI. This is important because the NHI is unlikely to have sufficient funding to provide an extensive package of benefits. This is because our country unfortunately faces significant financial constraints linked to low economic growth and a very narrow tax base. Medical schemes will therefore still play a significant role post full implementation of the NHI.

The Act will be legally challenged – we need a workable NHI

Having said all of the above, the Act remains problematic. The NHI will only be workable if it provides universal access to care for all South Africans, while not restricting the rights of medical scheme members. As stated above, to achieve this requires collaboration between the public and private healthcare sectors, which the Act fails to facilitate on a sustainable basis.

To achieve sustainability, we need more sources of funding for healthcare, not less. We need more doctors and healthcare professionals and resources, not less. Importantly, a workable NHI requires the public sector to be strengthened, not the private sector to be weakened. We need both to be strong and working together effectively.

In addition, we need to ensure that our country’s healthcare systems – our doctors, our nurses, our hospitals and others – are secure and sustainable. South Africa has brilliant and committed healthcare professionals. We need to grow their numbers and for them to feel secure in their roles and futures.

In light of these issues and other concerns, the Act is likely to trigger a range of legal challenges. Discovery will also take the necessary action as required.


We understand that President Ramaphosa’s signing of the NHI Act has caused anxiety. However, with full implementation a long way out and many matters still to be navigated, I urge you to focus on the facts. Rest assured that we will do the right thing for you, the healthcare system and for all South Africans.

Adrian Gore
Group Chief Executive
Just like land expropriation, the problem is not the ANC implementing it, it is simply the threat that destroys our economy.
I read that the Department of Health's best-case plan for implementing it is 15-20 years. At this point the funding has not been planned for or allocated for at least the next 3 years. Looking realistically, it took Japan 34 years to implement something similar.