The National Health Insurance Act 20 of 2023 : navigating constitutional obligations and the risk of regulatory overreach.

Abstract

This study examines South Africa’s National Health Insurance Act 20 of 2023 (NHI), a pivotal law implementing a universal healthcare coverage (UHC) model for South Africa. Section 27 of the South African Constitution permits the government to implement the national health insurance policy to guarantee social protection for all citizens. It will ensure equal access to comprehensive health services for all citizens, regardless of their financial status. The study examines the Constitutional responsibilities of national health insurance and potential regulatory overreach. Concerns about the national health insurance’s implementation include, integrating private providers and health insurers into the public system, the viability of a single-payer model, and the potential restriction of Constitutional rights for critical stakeholders. The main goal of this study was to examine the complexities related to the national health insurance and national health insurance fund while proposing recommendations for implementing national health insurance successfully. This was achieved by thoroughly analysing the legislation and stakeholder concerns, including the influence on the private healthcare sector. The analysis and contentious issues identified provide a detailed understanding of the national health insurance’s influence on the healthcare system, offering crucial insights for policymakers and stakeholders. This research structures the conversation on healthcare reform in South Africa, emphasising the need for a balanced approach considering Constitutional mandates and practical healthcare needs.