DEFENCE OF THE NATIONAL HEALTH INSURANCE
BY : CHANON LECODEY MERRICKS ONLINE EDITOR KASiBC_AFRiCA
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ANC STATEMENT IN DEFENCE OF THE NATIONAL HEALTH INSURANCE
The African National Congress (ANC) notes the proceedings before the Constitutional Court concerning legal challenges to the National Health Insurance (NHI) Act. These proceedings take place at a historic moment in the life of our democracy, as South Africa prepares to commemorate 30 years since the adoption of the Constitution on 8 May.
This milestone calls on our people to reflect on the gains of democratic transformation, while confronting the enduring legacy of apartheid that continues to shape access to basic services, including healthcare. At the heart of this matter lies a fundamental constitutional question: whether the right of access to healthcare, as enshrined in Section 27 of the Constitution, should remain dependent on income, or whether it must be progressively realised as a universal entitlement for all. Section 27 is unequivocal that everyone has the right to access healthcare services, and that the state must take reasonable legislative and other measures, within its available resources, to achieve the progressive realisation of this right.
The NHI Act represents a decisive and revolutionary step in giving practical expression to this constitutional mandate. It affirms a society in which healthcare is not a commodity for sale to the highest bidder, but a public good anchored in equality, solidarity and human dignity. In this context, the ANC views the NHI as a historic instrument to dismantle the entrenched inequalities that continue to define South Africa’s health system. More than three decades into democracy, access to quality healthcare remains structurally determined by socio-economic status. This dual system, one for the affluent and another for the majority, stands in direct contradiction to the values of equality and dignity that the Constitution seeks to entrench.
The NHI seeks to correct this historical distortion by pooling the nation’s resources to ensure universal and equitable access to quality healthcare services. The ANC approached the current challenge against the NHI Act with the full knowledge, from extensive consultations with communities and organisations, that the people of South Africa support its efforts to make the NHI a reality. It is further encouraged by its confidence in the Constitution of the Republic and the South African legal system, as these provide adequate and robust remedies, namely constitutional, parliamentary, administrative, civil and criminal, that protects the integrity of policymaking and lawmaking.
The ANC holds the conviction, based on the democracy that has been built from 1994 to date, that any individual, organisation, business sector, political party, or interest group that obstructs, manipulates, or distorts constitutional processes of policymaking and lawmaking commits a constitutional and legal transgression. Those who oppose the NHI, including through legal challenges before the Constitutional Court, are in effect seeking to preserve a system that reproduces inequality and delays the full realisation of constitutional rights. While often presented in technical or legal terms, such opposition has profound social consequences. It risks entrenching a reality in which dignity is conditional and access to healthcare is determined by wealth rather than need.
The ANC holds the view that this position of using various means to oppose this noble law, the NHI Act, is inconsistent with both the letter and the spirit of the Constitution, particularly its founding values of equality, human dignity and freedom. Beneath these objections lies a deeper material reality. NHI challenges entrenched privilege. It disrupts a system in which quality healthcare is effectively rationed by income, where private hospital groups and medical aid schemes thrive alongside a chronically under-resourced public health system that serves the majority. Resistance to the NHI is therefore not only about constitutional interpretation, but also about the defence of privilege, structural advantage and historic inequality.
The NHI is grounded in the principle of solidarity, recognising that the health of one is inseparable from the health of all. It gives concrete meaning to the constitutional commitment to redress historical injustices and to build a society based on social justice. Far from undermining the Constitution, the NHI is one of its most transformative expressions in practice. As we mark 30 years of constitutional democracy, we are reminded that the Constitution is not a static document, but a living instrument of transformation. It obliges the democratic state to take deliberate and progressive steps towards substantive equality.
The ANC remains confident that the Constitutional Court will uphold the constitutionality of the NHI and affirm the state’s obligation to progressively realise the right to healthcare. The ANC reaffirms its unwavering commitment to the NHI as a necessary, just and constitutionally grounded step towards a more equal, dignified and humane South Africa.
The ANC is encouraged by the spirit of unity and collaboration that has been demonstrated in the long journey and joint meetings of the Congress Alliance and in the support for the NHI that civil society organisations and most citizens have demonstrated over the years.
Together we will deliver the National Health Insurance to the people who need it most, towards equitable access to healthcare for all and Universal Health Coverage (UHC) in our country.
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