While South Africa’s private healthcare system is still widely regarded as one of the few parts of the country that functions well, a new report reveals a deep unease about the future—especially with the government’s National Health Insurance (NHI) plan starting to roll out.
What Healthcare Professionals Are Saying
In Profmed’s 2025 State of Health Report, nearly 1,800 medical professionals were surveyed—and the message was clear: the majority of them aren’t sold on the NHI plan.
About 70% of respondents said they were satisfied with the overall standard of healthcare, mostly thanks to the private sector.
However, a staggering 75% said they do not believe the NHI will actually improve healthcare delivery in South Africa.
In fact, most fear it could do more harm than good.
Medical Aid Costs Still a Big Issue
One topic that came up over and over again was the rising cost of medical aid.
According to Profmed CEO Craig Comrie, affordability is a serious concern.
But there’s a potential solution—some believe that if medical aid became mandatory for all formally employed South Africans, it could cut costs by up to 30%.
Still, there’s a catch: any attempt to regulate prices must also be paired with smarter governance, better use of resources, and meaningful reform in the public healthcare system.
Public Healthcare Faces Trust Issues
And when it comes to public healthcare, the outlook is even bleaker.
Six out of 10 respondents said they have no faith in the public system at all.
Why? The list of complaints is long—staff shortages, rundown facilities, and a lack of accountability top the list.
Many medical professionals believe that unless these issues are addressed, trying to overhaul the entire healthcare system with a massive project like the NHI could backfire.
Government Pushes Ahead With NHI Plans
Despite the concerns, Health Minister Aaron Motsoaledi has made it clear that the government is not backing down.
In his recent budget vote speech, he confirmed that NHI implementation is moving forward.
He added that significant funds are already being directed toward upgrading public healthcare infrastructure to get it ready.
The government insists that NHI will provide universal and fair access to healthcare, no matter your income or status.
But for many doctors on the ground, that promise only works if the state also gets serious about financial transparency, better management, and working alongside the private sector instead of against it.