Here’s what the new (NHI) healthcare system could cost the taxpayer

  1. Several industry experts, including Intellidex analyst Peter Attard Montalto, believe that NHI would cost SA R165 billion.
  2. Meanwhile, it was this time last year that the health department “guesstimated” they’d need R259 billion.
  3. The Institute of Race Relations (IRR) has also calculated that the current cost of healthcare in South Africa is R450 billion.

Recent Treasury figures show that there are roughly 21 million taxpayers in South Africa. However, only 30% of them – about 7.6 million – are actually registered to pay tax or sit above the annual income threshold. There are a total of 58.775 million people in South Africa, so we thought we’d ask – what would NHI cost each and every single one of us each year?

The low-range estimate from industry experts: R165 billion

  • If all taxpayers contributed: R7 857 per person
  • If registered taxpayers only contributed: R21 710 per person
  • If everyone in South Africa had to contribute: R2 807 per person

The mid-range estimate from the government: R259 billion

  • If all taxpayers contributed: R12 333 per person
  • If registered taxpayers only contributed: R34 078 per person
  • If everyone in South Africa had to contribute: R4 406 per person

The high-range estimate from the IRR: R450 billion

  • If all taxpayers contributed: R21 428 per person
  • If registered taxpayers only contributed: R59 210 per person
  • If everyone in South Africa had to contribute: R7 656 per person

The much-maligned National Health Insurance (NHI) bill has been criticised from pillar to post this week after it was tabled for Parliament’s consideration. Plans to prevent its rollout are already well underway, as medical professionals and opposition political parties vehemently oppose the proposals.

The main fears stem from the fact that NHI would essentially be another state-owned entity. Considering how the likes of Eskom, Denel and SAA have performed recently, there is very little appetite for another mouth to feed. Concerns have also been raised about the state getting to dictate salaries, medicine prices and treatment methods.

But one of the biggest woes is centred around the taxpayer. The bill, although vague in some regions, makes it clear that the funding would come from the pockets of the public. They are targeting the following areas:

  • General tax revenue, which will include transferring funds from provincial health budgets to the NHI Fund.
  • Taxpayers’ medical scheme fees tax credit will be reallocated to the NHI Fund.
  • A payroll tax (employer and employee).
  • A surcharge on personal income tax.

In what appears to be a stunningly-brazen raid on the taxpayer, the ANC have been called out for trying to inflict another financial disaster on South Africa. The bill also obscures the true costs of what the NHI rollout would cost. So far, three figures – each more wince-inducing than the last – have been punted:


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