The Department of Health invites you to submit written comments on the proposed National Health Insurance Bill (NHI) and the Medical Schemes Amendment Bill.

You are invited to object or support the Bills by providing comment below. Should you be unsure, read the live comments, a summary or official documents below the form.   Closing date is midnight 21 September 2018.

20721 active citizens in this campaign, so far.

Add your comment now.

Select NO or YES to the Medical Schemes Amendment Bill
No to the MSA BillYes to the MSA Bill

Select NO or YES to the National Health Insurance (NHI) Bill
No to the NHI BillYes to the NHI Bill

Which Bill do you want to comment on?
the Medical Schemes Amendment Billthe National Health Insurance (NHI) Billboth bills

Check your email address is correct then hit send!

A copy of your message will be sent to you along with an automated proof of receipt. Check your junk mail folder if you can’t find it.


Displaying newest 5 comments sent.

No to the MSA Bill
No to the NHI Bill
As a 77-year-old person who is no longer a salary earner and who has over the years paid (and continues to pay) a monthly amount to a Medical Aid fund, I am presently able to access such medical treatment I choose both timeously and reasonably affordably. There is, in my income tax assessment, an income tax rebate received in the form of tax credits on medical scheme fees and other medical expenses which have been paid by me; this assists greatly in mitigating the costs to me. However, proposed Section 49 (2) (ii) states a major source of NHI income by “reallocation of funding for medical scheme tax credits....towards the funding of National Health Insurance;” I am concerned that my Income Tax Medical Rebates may be withdrawn, but that the proposed NHI may prove unable to timeously provide the services needed by me.

I have budgeted my retirement funding savings with care, so that in my later years my rising health care expenses are reliably provided for. It seems grossly unfair to impose on my spouse and me an unproven system which may prove to be disastrously inadequate.

The proposed NHI Bill states one object is to “achieve the progressive realisation of the right of access to quality personal health care services” It seems to me the proposal would remove my current right of access to such services as I can afford, without any guarantee of supplying alternative ‘quality health care services’. The Preamble states: “in terms of section 27(2) of the Constitution the State must take reasonable legislative and other measures, within its available resources, to achieve the progressive realisation of the right of access to health care services”. The measures ‘within its available resources’ may prove to 0be considerably less than the measures which I can currently obtain in the private health care system as it presently stands.

The private health care system seems to be flexible enough to take timeous advantage of new developments in medical science. It worries me that the public health care system envisaged in the NHI Bill may not be similarly able to adapt.

Our constitution provides some basic human rights about freedom of choice with respect to health care providers whom I may wish to use. I note that a user “must first access health care services at a primary health care level as the entry into the health system” and “must adhere to the referral pathways prescribed for health care service providers or health establishments”. To me, this implies that my freedom of choice is being removed, denied or severely curtailed.

I believe the proposed NHI could be phased in for younger citizens and that older citizens should be allowed to elect to continue with the current private health system. There is no option for pensioners and retirees to work harder or for longer hours to earn more, in order to pay for the additional costs of belonging to an NHI system, whether those costs be in the form of additional income tax or in withdrawal of tax rebates currently in force. For many of us, we have budgetted based on rules currently in force by SARS and any major change would be financially crippling.

Submitted 2019-10-10
No to the MSA Bill
No to the NHI Bill
Freedom of choice is a cornerstone of a democracy. As I citizen I have a right to choose my service provider without being forced by an incompetent government to make use of a service which is not my choice.
No to the MSA Bill
No to the NHI Bill
Can our government first focus on how to fix their country as it "stands" ie. public hospitals to provide half decent amenities and available beds/ equipment for the less privileged without private medical aid, public transport (trains), unemployment, poverty, crime, corruption within the government....!!

If the above basic services and morals cannot be carried out or provided currently then HOW do they expect to fund, manage and succeed with NHI . It is just another way to take a tax payers money.. I am happy to pay the amount of money I pay to my medical scheme as I know I will have a clean hospital bed to lay in if I fall ill or get hit by a car tomorrow.. This will not be the case with NHI I can assure you. ...sadly
No to the MSA Bill
No to the NHI Bill
South Africa is already so far in debt, and implementing the NHI Bill will just push South Africa more into debt. It is a very expensive experiment, which will only come of the small 13% of south african population paying tax. It is impossible to ask 13% of the population to carry the whole of South Africa. The tax payers already pay a significant amount of tax, which is much higher than the rest of the world, and already they are not receiving any service that that contribution they give.

Public health is a disaster, and service is very slow, and this Biill will just make everything worse

it is impossible to work
No to the MSA Bill
No to the NHI Bill
The current state run medical facilities are terrible with many people waiting all day for help.
I rather pay for private medical aid before I risk my life there. It is my right to decide what medical aid I want to invest in.
The more funds in state coffers the more will be stolen. Government can't keep the state facilities in good order now so how will they manage when everyone are forced to go there?!

This will never work!!


The National Heath Insurance (NHI) Bill aims to;

  • provide mandatory prepayment health care services in the Republic in pursuance of section 27 of the Constitution;
  • establish a National Health Insurance Fund and to set out its powers, functions and governance structures; to provide a framework for the active purchasing of health care services by the Fund on behalf of users;
  • create mechanisms for the equitable, effective and efficient utilisation of the resources of the Fund to meet the health needs of users;
  • preclude or limit undesirable, unethical and unlawful practices in relation to the Fund and its users;
  • provide for matters connected herewith.

The Medical Schemes Amendment Bill aims to;

  • amend the Medical Schemes Act, 1998; so as to exclude the application of the Consumer Protection Act, 2008, in relation to matters governed by the Medical Schemes Act;
  • extend the functions of the Council;
  • insert a new section 8A in terms of which the Council may require information from medical schemes concerning the services rendered by the health care providers to beneficiaries;
  • insert a new Chapter 3A providing for the creation of a Central Beneficiary Register and the management of that register by the Registrar and to establish risk measurement methodology;
  • redetermine the provisions relating to the admission of beneficiaries to a medical scheme and the cancellation of membership;
  • insert a new Chapter 5B, in relation to the various requirements applicable in determining the contributions payable to a medical scheme by its members;
  • provide for a Health Care Providers Register to be kept and maintained by the Registrar;
  • repeal certain sections;
  • re- determine the provision dealing with the establishment of the Appeal Board;
  • introduce an enhanced system of governance of medical schemes under the new chapter 11A;
  • empower the Council to determine broker fees from time to time and define the circumstances in which a medical scheme may receive payment of broker fees due by its members to a broker;
  • declare the carrying on of the business of a medical scheme by a person not registered as a medical scheme to be a separate offence,
  • prescribe the criminal penalties that may be imposed on persons convicted of that offence;
  • provide for matters connected therewith.


Download the Medical Schemes Amendment Bill

Download the National Health Insurance Bill (NHI)

DearSA - National Health Insurance

Important to note; this is not a petition but is the first step in an essential Participative Democracy process protected under the SA Constitution. Your comment is immediately sent as a unique email to the designated government representative and must, by law, be individually acknowledged and considered. Had this been a petition, all comments would be seen as a single submission.

By using this service you ensure an accurate record is held by civil society (on our encrypted database) so government cannot fudge facts or figures. This process forms a solid foundation for a legal case should the necessity arise.


There’s no time better than now for you to sign up to Noseweek. For a limited time only we’re offering a 20% discount on online subscriptions. You get to read 12 issues for just R244 (R21 per issue) and can access our entire 25-year searchable archive at your convenience and at no extra cost! Click to visit Noseweek.