South African Health Minister Zweli Mkhize on Thursday defended the National Health Insurance (NHI) bill which has met with growing criticism, saying the country was following an international trend in implementing universal health care.

Universal healthcare insurance is a global movement and it is not South Africa moving on its own, the minister told Parliament’s Portforlio Committee on Health.

“All countries that instituted national health insurance are in a better economic state now than when they started,” he said.

The NHI bill is procedurally correct and bench-marked internationally, Mkhize said.

He, however, acknowledged that the bill makes South Africans nervous because of various issues in the public domain.

Earlier this month, Mkhize submitted to Parliament the bill which envisages a package of comprehensive health services for free at private and public health facilities as part of the government’s bid to provide more equitable access to quality healthcare.

The landmark bill will benefit all South African citizens, permanent residents, refugees, inmates, designated foreign nationals and all children.

But critics say the financing model of this bill will mean the imposition of a new tax on ordinary South Africans who have already been squeezed dry by the government and cannot be subjected to yet another tax.

Several political parties and numerous bodies, including the South African Private Practitioners’ Forum, voiced skepticism about the bill, calling it unrealistic, too expensive, and would potentially damage the healthcare sector, particularly when the country is facing a financial crisis.

The purpose of the bill is to establish and maintain a NHI Fund financed through mandatory prepayment that aims to achieve sustainable and affordable universal access to quality healthcare services.

The fund will operate on the basis of single purchaser and single payer of healthcare services, by pooling funds and strategic purchasing of healthcare services and goods from accredited and contracted healthcare service providers, according to Mkhize.

Once the NHI is fully implemented, the health minister will introduce regulations limiting medical scheme benefits to services that are not reimbursable by the fund, the Department of Health said.

On Thursday’s briefing, Ayesha Johaar from the Office of the State Law Advisor said the bill is constitutionally sound.

“We are therefore satisfied that Parliament, in passing the proposed legislation, would not be acting capriciously and arbitrarily, in violation of the rule of law, thereby rendering such legislation inconsistent with the Constitution,” said Johaar.