Health Minister Aaron Motsoaledi has come out guns blazing against Solidarity’s legal challenge to the National Health Insurance Act, arguing that the trade union’s case is devoid of merit and reflects its ‘discriminatory and elitist ethos’.

‘What appears to be the nub of Solidarity’s complaint is its discomfort with the fact that the majority of the population who now use the public healthcare system will be afforded access to private healthcare providers and facilities under the NHI Act, which are now the exclusive domain of those who are better off,’ he said in court papers.

A Business Day report notes Solidarity was the first organisation to attempt to overturn the Act.

The Board of Healthcare Funders, representing medical schemes and administrators, and the SA Private Practitioners Forum, representing healthcare professionals, followed suit soon after.

Solidarity asked the Gauteng High Court (Pretoria) to declare the Act unconstitutional and invalid. It argued that the Act is vague, impractical, unaffordable, and unconstitutional on multiple grounds.

One key objection centres on the Act’s limitations on the future role of medical schemes, which it maintains will erode members’ existing access to healthcare and is thus regressive and at odds with the Constitution.

In his responding affidavit, the Minister said the Act was designed to tackle inequity between private and public healthcare, which was ‘much worse than ... under apartheid. Our Constitution demands a healthcare system that is equitable and transformed, and which puts human life and dignity at its centre. This is what the Act is designed to achieve and what it will achieve.’

As NHI is to be implemented in stages, medical schemes would operate much as they do today for at least another decade, said the Minister.

‘I estimate this to be a period of between 10 and 15 years,’ he said.

‘There will be a period when both the NHI fund and medical schemes are permitted to cover similar services before the Minister declares the Act to be fully implemented. This will be a necessary part of the process to protect healthcare users from being without cover during the process of moving from medical schemes to the fund,’ he added.

According to the Business Day report, he said the Act did not limit healthcare access.

‘If there is a benefit which a user would like to access which is not covered by the NHI fund, the user is at liberty to pay for it out of pocket or access complementary medical scheme coverage,’ he said.

‘This is similar to the scenario which plays out now with medical aids and has been implemented for many years without challenge. A simple example is that when a medical aid beneficiary has depleted their allocated funds (in a medical savings account for example), the beneficiary must pay out of pocket.’

Full Business Day report