The NHI is a power grab – and it puts your life in the worst hands possible
Nobody in their right mind would willingly put their life in the hands of Cosatu
Written by: Eustace Davie
Nobody in their right mind would willingly put their life in the hands of Cosatu.
The National Health Insurance (NHI) Act is not reform. It is not about healthcare. It is a power grab – one of the most sweeping in South Africa’s democratic history. It hands control over life and death to the most demonstrably immoral, corrupt, uncaring, and self-centred group in the country: the ruling elite and their union backers.
No one who has witnessed the decay in our state hospitals would entrust those responsible with greater power. No one who has watched a loved one lie unattended, or witnessed patients abused and humiliated by staff, would willingly surrender the right to choose better healthcare. And no government that respects individual liberty would pass a law compelling them to do so.
Centralised control, criminalised choice
The NHI Act does not merely create a new funding model. It outlaws most private medical cover. It prohibits citizens from paying for care the state claims it will provide. It forces doctors into government contracts under centrally dictated terms. It compels every South African to rely on a single fund, under political control, for access to care.
This is not universal healthcare; it is government monopoly by force.
It traps the population in an already broken system and then bars the exits. It criminalises alternatives and removes the right to seek better care. It grants the state total control over what services exist, who provides them, and who may receive them. It is not about improving outcomes. It is about expanding control.
Entrusting the untrustworthy
Who will wield this control? The very people who have already failed spectacularly: the ministries, unions, and cadres who cannot keep public hospitals clean, who cannot pay doctors on time, and who shield incompetence while rewarding loyalty over skill.
Through NEHAWU, COSATU already exerts power over hospital staffing, discipline, and operations. Managers cannot enforce basic standards without union retaliation. Corruption goes unpunished. Whistle-blowers are silenced and, in some cases, murdered.
The NHI Act places your life in their hands – and offers no alternative.
Privilege protected, accountability abolished
The political elite will never use the NHI; they do not even use the current state healthcare system. They receive private care, often abroad, always at public expense. Military hospitals remain on standby for their benefit. The Act does not abolish these privileges. It conceals them. As in every failed socialist system, equality is preached but access to the best services is reserved.
Meanwhile, ordinary South Africans will be forced into queues, locked into waiting lists, and denied even the right to pay for treatment when the system fails. The law forbids it.
This is not reform, but control masquerading as compassion.
A moral line must be drawn
The ANC does not fix what it controls. It captures it, loots it, and shields it from scrutiny. The NHI Act will be no different. It does not empower patients. It disempowers them. It does not expand care. It criminalises private care. It gives absolute power over every South African’s health to those least fit to wield it.
The state cannot clean its wards, stock its pharmacies, discipline its nurses, or guarantee basic decency in its hospitals. It therefore has no standing to prohibit citizens from seeking better care elsewhere. South Africans opposing this power grab have rightly taken the matter to court. The Health Funders Association, South African Medical Association, Hospital Association of South Africa, Board of Healthcare Funders, Solidarity, and the South African Private Practitioners’ Forum are all challenging the Act’s legality.
Their efforts deserve the support of every citizen who values liberty, dignity, and the right to choose. All South Africans who cherish these principles must reject this law.
Eustace Davie is President of the Free Market Foundation and the author of Jobs for the Jobless and Unchain the Child.