NHI: 'Business must stop grovelling and realise its power to oppose NHI' – FMF  
David Ansara, Chief Executive Officer of the FMF

‘Organised business must change its future approach to dealings with government, and reject the NHI proposal with the contempt that it deserves.’ – David Ansara, Chief Executive Officer of the FMF

Yesterday, the Select Committee on Health and Social Services in the National Council of Provinces adopted the National Health Insurance (NHI) Bill without any changes, despite assurances to business associations that the Bill would be softened. This development is further proof that government was never intent on incorporating the inputs and suggestions made by the private sector. 

‘The Free Market Foundation (FMF) has long called on business to not assume good faith from the government. Its naïvety will cost commerce and all South Africans dearly,’ said David Ansara, CEO of the FMF. ‘We now face the collapse of the private healthcare sector, which will mean that countless jobs will be lost, along with quality service and freedom of choice in healthcare.’ 

Business should never have accepted NHI ‘in principle’. This concession did not buy them any political capital. Organised business has been focused on amending section 33 of the Bill. This provision will, once the NHI is fully implemented, prohibit medical schemes from offering benefits covered by the NHI Fund. But the NHI is bigger than only section 33, and touches on constitutional liberties and governance. Business’s narrow approach is misguided. NHI represents a fundamental assault by the state on the independence of private healthcare, and should be opposed in its entirety. 

‘Business has no reason to grovel before a malicious government for minor concessions. The commercial sector in South Africa is significantly stronger and more capacitated than the public sector. Business needs to start taking the lead, rather than reinforcing the harmful agenda of the government,’ continued Ansara. 

Business’s attempts to substantively water down NHI have failed. This strategy must change. Business’s leadership role in this context should be to defend the interests of healthcare consumers, medical professionals, and shareholders, not to toe the line of the brazenly ideological programme that is the NHI. 


The NHI Bill infringes upon several rights that are enshrined in the Constitution. It will prevent medical schemes from covering services covered by the NHI, which will deny everyone the right to receive healthcare from service providers of their choice.  

‘The NHI’s imposition effectively nationalises the private healthcare sector, forcing doctors to become servants of the state or, in the more likely event, emigrate,’ said Martin van Staden, FMF Head of Policy. 

The FMF Health Policy Unit has long warned of the NHI’s weak governance model, which will enable political interference in key components such as setting up the NHI board and its numerous subcommittees. This is likely to result in politically aligned cadres managing an NHI budget that is in excess of R500 billion annually. The constitution of the NHI Fund flies in the face of the Zondo Commission’s insights and recommendations. 

‘The Free Market Foundation insists that organised business must change its future approach to dealings with government, and reject the NHI proposal with the contempt that it deserves,’ concluded Ansara.