The flawed draft regulations for the National Health Insurance (NHI) Act have, according to AfriForum, once again confirmed that the South African government is incapable of launching or managing such a complex system. Due to the numerous court cases brought against NHI and the state’s enormous budget deficit, it was questioned whether the Minister of Health should have proceeded to publish draft regulations. Now, the published draft regulations lack any clarity about what South Africans can expect from the system.

Louis Boshoff, Campaign Officer for Health at AfriForum, says some of the regulations are so poorly written that they contain even less detail than the original explanatory articles of the NHI Act. Other regulations and sub-regulations are simply confusing or so vague that various interpretations can result from them. For example, Sub-regulation 25(7) states that proposals from the advisory committee must be approved by the Minister and then implemented by the fund, while Section 56(1) of the NHI Act only states that the fund may issue directives to implement the law. It is therefore unclear exactly what the role of the Minister, the advisory committee and the fund is.

“The NHI Act was criticised from the outset as unclear and ambiguous and it was hoped that the regulations would bring more clarity on how the system was supposed to function, but now the draft regulations have done nothing to provide greater clarity,” says Boshoff. “How can a Minister and Department of Health, that cannot even write well-thought-out regulations, be expected to manage this highly complex system?”

AfriForum will submit its full comments on the draft regulations in the coming weeks but emphasises that the NHI Act should rather be scrapped as a whole. “Over the past year, it has become very clear that regulations – even good regulations – cannot make up for weak or discriminatory legislation. All the more so that these low-quality regulations offer no solution,” concludes Boshoff.