In order to pay for NHI in 2014-15, an initial amount of R6 billion will need to be raised to fund the shortfall that is expected between expenditure and income generated.
This equates to 0.5% of total payroll should payroll tax be used to fund the shortfall.
However it is still not clear if the funds will be raised through payroll tax, VAT or a surcharge on income tax.
The amount required to pay for NHI, will rise substantially over the next 14 years. By 2025 the shortfall is likely to rise from 4% to 6% of Gross Domestic Product.
NHI is a desirable objective. The cost and impact on hard pressed taxpayers is however likely to be a major cause of dissatisfaction in years to come.
So if the whole Sanral E-toll debacle is anything to go by – wait until government proposes that individuals are now forced to join the states NHI for which you may be charged anywhere from 4 -8% of your income – Yes its proposed that each employed person contribute towards the NHI WaBezi fund + Your e-toll account + your current tax deductions and and and… If you still think you work for yourself …
This is a hot potato that government needs to reconsider as it’s essentially completely unaffordable and almost impossible to implement. Having said that – there is more than an urgent need to deliver free or affordable and accessible healthcare to those in need – a solution must be created – more efficient use of current facilities, better use of health care budgets of which currently more than 80% of funding goes towards salaries and not infrastructure or improving or building new clinics. There’s no quick fix solution for this one.