NHI Frequently Asked Questions

NHI Frequently Asked Questions

What is the National Health Insurance (NHI)?

The NHI is a financing system that will pool funds from government and tax bases into a central fund solely controlled by the health department, that will purchase health services to meet the needs of the population.

The NHI is “ The National Health Insurance (NHI) is a health care financing system that is designed to pool funds to actively purchase and provide -access to quality, affordable personal healthcare services for all South Africans based on their health needs, irrespective of their socioeconomic status.” 

When will the NHI start?

A pilot programme to strengthen the NHI implementation was rolled out in 2012, through a series of rollouts, the full NHI is meant to be in effect by 2026.

What does the NHI mean for me?

It means access to a financially secure way of accessing equitable healthcare. With the NHI everyone has access to the same services and service providers when needing primary health care. People pay a   fee into the NHI fund according to their financial means, but access to health services is not determined by how much money you have. 

Why do we need the NHI? 

Healthcare is a human right – this is a widely accepted international principle. This right should not depend on how rich we are or where we happen to live. The right to obtain healthcare is written into our Constitution.

How can I learn more about the NHI?

Visit to read more on our submission, or read the NHI bill for yourself here gov

Can you put me on the NHI? is not connected with the government, or the NHI. Parliament is currently asking for public comment on the NHI Bill. If NHI is passed, then it will be implemented over time with everyone having access to the NHI. You can’t sign up for the NHI now. For more information on the NHI, you can contact the Department of Health. 

I heard the NHI pilot was a disaster? 

That’s why it is more important than ever that we the people are involved with this process of public comment, and that we continue to hold government, the private sector, and others accountable to make sure the NHI delivers quality healthcare for all.

I don’t trust public clinics/ hospitals etc, isn’t it safer and better to get on medical aid and access private health services?

The Competition Commission has been investigating private healthcare providers and just released their report. It has been exposed that medical aids are profiteering and consumers are not getting good value for money.

I’m worried the NHI will not work because of corruption

Government has just launched the Health Sector Anti-Corruption Forum. The forum will involve civil society, SIU, NPA and health bodies to work together and watch out for corruption and act.  The forum will work to address corruption and state capture, not just in public hospitals, but also in the private sector as the Competition Commissions Health Market Inquiry has exposed overpricing and overtreatment in the private sector.

But more needs to be done to stop the fat cats and companies from corrupting the NHI. We are calling on our leaders to do the following to reduce corruption in our health system and the NHI. 

Inequality and corruption are linked, and in SA corruption is both a feature of the private and public sector. Austerity and conservative economic policies are not going to reduce inequality, but progressive ideas such as the NHI could reduce inequality. 

But this will only be achieved if the NHI fund is accountable and can’t be captured by either the public or private sector. Measures such as regulation can ensure the accreditation of service providers. The accreditation process needs to be in line with the NHI’s goal to serve people, and give satisfactory health services to shown +-health needs. Civil society must have enough mechanisms and representation to stop the NHI fund from being captured by greedy companies, fat cats, corrupt politicians or unaccountable bureaucrats. 

How will the government/ National treasury finance the NHI?

Section 49 ( Chapter 10) of the NHI Bill reveals that the chief funding for the system will be procured through general taxes, a re-allocation of tax credits and a payroll tax, calculated according to income levels.

Do we know which healthcare services will be provided within the NHI? 

The NHI will offer all South Africans and legal residents access to a defined package of comprehensive health services.

According to Section 40(1) of the Bill; There will the Fund in the NHI which will establish an information platform to enable it to make informed decisions on population health needs assessment, financing, purchasing, patient registration, service provider contracting and reimbursement, utilisation patterns, performance management, setting the parameters for the procurement of health goods, and fraud and risk management.

After my public submission, what will happen next? 

The NHI Bill will be tabled in Parliament and will be in the hands of the Portfolio Committee on Health, which will hold formal hearings in early 2020. There will also be a parallel process within NEDLAC, which will create further opportunities for business, labour and government to engage in the final content of the Bill. We expect the Bill to be finalised sometime during 2020 at the earliest.

What has been the process fo far for the NHI being passed as law?

Green Paper: is the first step towards legislation.  The purpose of the green paper is to put forward various policy options on a particular socio-economic/ political topics by a ministerial body or department. The paper invites public commentary and creates debate on the policy without actually committing to any specific action. 

White paper - This paper signifies a clear intention on the part of the Government to pass a law.which is a broad statement of government policy. It is drafted by the relevant department or task team and the relevant parliamentary committees may propose amendments or other proposals. After this, it is sent back to the Ministry for further discussion, input, and final decisions.

 Bill- A bill is a proposal by the government; it is not the final statute but it is usually published in the Government Gazette to allow public comment on the bill. The Minister is responsible for all the readings of the Bill and comments.


How will the payment of health care providers be determined? 

Section 41 of the Bill provides for provisions for the payment of health care service providers. It is stated that the Fund in consultation with the Minister will determine the nature of payment and mechanism. The NHI must ensure that health care service providers, health establishments and suppliers are properly accredited before they are reimbursed. An accredited primary health care service provider must and will be contracted and remunerated by a Contracting Unit for Primary Heal.