However, despite being a formal government policy goal since the ruling ANC’s 2007 national conference -- and the subject of extensive critical debate and public consultation since -- the bill remains largely unchanged from decades-old proposals, and critical details remain undefined.
Concerns about the NHI may led to higher volumes of emigration among medical and other skilled professionals.
Brain drain may reduce income tax receipts, which provide over one-third of government revenues but come largely from high-income earners.
The bill will greatly diminish the role of provinces in public health provision, which may fuel tensions with the national government.
Implementation costs may complicate the government’s wider macroeconomic goal of fiscal sustainability.
