**Towards Equitable Access to Universal Health Care: A Compulsory Approach**
Universal access to quality health care is a constitutional imperative, a legal and moral obligation enshrined in Section 27 of the Constitution. Despite this guarantee, health inequality persists in South Africa, where only 16% of the population receives private health care, leaving 84% dependent on an underfunded and overburdened public system. This disparity perpetuates structural inequalities and deprives the majority of South Africans of quality health care.
The establishment of the National Health Insurance (NHI) scheme aims to correct this imbalance by guaranteeing everyone access to health care, regardless of income or socio-economic status. Despite reluctance and criticism, particularly from the opposition and some private sector actors, the effort to establish the NHI is essential to ensure equitable health for all.
Much of the opposition to the NHI is driven by financial interests, particularly in the private health sector, which has seen exponential profits at the expense of affordability for the majority of South Africans. Profits for large hospital groups and health insurance companies have increased significantly, often outpacing inflation and GDP growth.
The argument that the NHI would bankrupt the country is based on misrepresentations and exaggerations. International models of universal health care show that such systems are not only affordable, but also improve overall health outcomes. Countries such as Thailand, South Korea and Canada have implemented universal health systems at costs far below those claimed by NHI critics.
For South Africa, the estimated cost of the NHI can be financed through progressive taxes, reallocation of existing resources and efficiency gains through bulk purchasing. Integrating private health infrastructure into the NHI system will reduce capital costs for new facilities. Innovative financing mechanisms, such as a modest payroll tax, reallocation of existing resources and a dual contribution model, can ensure the financial sustainability of the NHI.
It is essential to recognise that the challenges faced in current public hospitals are not inevitable, but an opportunity for transformation through the NHI. A centralised approach to financing and oversight will improve accountability and promote improved healthcare for all South Africans.
In conclusion, the establishment of the NHI in South Africa is not only a constitutional imperative, but a crucial step towards health equityBy investing in a universal health system, the country will be able to guarantee quality care for all, promote social justice and strengthen its economic development in the long term.