• G C Solanki, N G Myburgh, S Wild, J E Cornell, and V Brijlal.
• Senior Specialist Scientist, Health Economics, Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; Honorary Research Associate, Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Principal Consultant, NMG Consultants and Actuaries, Cape Town, South Africa. geetesh.solanki@mrc.ac.za.
• S. Afr. Med. J. 2022 May 30; 112 (7): 456-464.

AbstractThe Portfolio Committee on Health (PCH) obtained public input on the National Health Insurance Bill from a wide array of individuals and organisations between May and September 2021. The record of these submissions collated by the Parliamentary Monitoring Group provided the source material for this article. The concerns, suggestions and other issues raised by respondents were analysed to determine what challenges and options the PCH needs to take seriously as they prepare the Bill for Parliament. Prominent issues raised included concerns about the proposed governance structure, flaws in the funding model, the risk of corruption, the constitutional and human rights at risk, limited access to care for several groups, and the unresolved nature of the medical benefits to be provided under the Bill. Future legal contestation of the Bill on several of these issues has the potential to stop or delay its implementation for a long time. The PCH has some hard decisions to make: whether to address these concerns with quite radical revisions of the bill, to omit problematic elements, or to leave it unchanged, and accept the contestation this will bring.

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