While US politics is descending into some nightmare version of The Handmaid’s Tale, South Africa’s opposing political parties have managed to come together rather maturely. The Government of National Unity (GNU) has finally reached a breakthrough on the controversial National Health Insurance (NHI) plan, and if you’re on medical aid, you might just breathe a sigh of relief. 

After months of drama, the ANC and DA have reportedly agreed to tweak the NHI Act, specifically Section 33, which would have banned medical aids from covering treatments provided by the NHI. That clause was a major sticking point, with critics warning it would wipe out the private healthcare sector.

Once upon a time, Republicans and Democrats in the US could have worked together in such a bipartisan way for the good of all citizens, but no more, as petty politics are increasingly dividing that society. We’re glad that’s not the case in South Africa.

So, what’s changing?

The biggest shift is in Section 33, which bans medical aid schemes from covering services provided by the NHI. DA leader John Steenhuisen confirmed the compromise, saying, “We will not be part of the destruction of private medical aids.” The agreement ensures that medical aids can continue operating, at least in some form, even after the NHI is rolled out.

The deal was struck after behind-the-scenes talks between Planning, Monitoring, and Evaluation Minister Maropene Ramokgopa, Health Minister Aaron Motsoaledi, and Steenhuisen at last week’s Cabinet lekgotla. President Cyril Ramaphosa has reportedly backed the proposal.

What does this actually mean?

🏥Medical aids stay – They won’t be scrapped when the NHI kicks in.

🏥New advisory council – A ministerial body will now figure out how private healthcare and the NHI can co-exist. The Department of Health will now iron out the finer details and integrate the changes into the government’s Medium-Term Development Plan.

🏥More funding options – The government is open to discussing how the private sector can be involved in a way that makes sense.

Motsoaledi, a long-time champion of the NHI, has been adamant that Section 33 is “the foundation” of the plan. He previously warned against removing it, comparing it to “supporting a house, but the foundation must go”. However, he has also acknowledged that “there is no law on earth that is cast in stone” and indicated some willingness to discuss modifications. We have to applaud the willingness to change his mind. 

But not everyone’s convinced. The Solidarity trade union is going ahead with its legal battle, arguing that the NHI is unconstitutional and completely vague on how it will be funded. Critics also warn that South Africa’s public healthcare system is already overloaded, and adding millions more patients could collapse it entirely.

We hear the concerns, but we can’t help but side-eye Solidarity for their negativity, given that they’re linked to Afriforum, who caused the massive drama with Donald Trump’s hysteria over our land reform policy. We’re still pretty impressed at how our parties have worked out a compromise on this one. And, for now, medical aid members can breathe easy—but watch this space.