84% of South Africans rely on public healthcare: Cyril Ramaphosa pushes NHI reform
Nearly 84% of South Africans depend on the public healthcare system, a reality President Cyril Ramaphosa says underscores the urgent need to bridge inequality in access to quality medical care through the National Health Insurance (NHI).
In his latest address to the nation, Ramaphosa highlighted the stark divide between public and private healthcare, stating that while South Africa has world-class medical expertise, it remains unevenly distributed.
“On average, the amount of money spent each year on a person who uses private healthcare is around five times what is spent on someone in the public sector,” he said, adding that “only around 16% of South Africans have access” to private facilities, compared to the majority who rely on state services.
The president used the recent successful separation of conjoined twins at Mankweng Hospital as a symbol of what the public system can achieve despite its challenges.
“This achievement is more than a medical milestone. It is proof of what our public health system is capable of,” Ramaphosa said.
However, he acknowledged that such successes are not the everyday reality for most citizens.
“For every story of excellence like Mankweng, we know there are too many South Africans who cannot access the quality healthcare they need and deserve.”
Ramaphosa said the imbalance between private and public healthcare systems effectively creates “two separate nations,” calling for stronger collaboration across sectors.
“These two parts of our healthcare system cannot continue to operate in parallel, as if serving two separate nations. They must work together in service of one nation,” he said.
The president positioned the NHI as central to addressing these disparities, describing it as “more than a funding mechanism” but rather a constitutional commitment to equal healthcare access.
“It is the instrument through which we will ensure that the skills and dedication on display at Mankweng are available to all our people, regardless of their ability to pay,” he said.
Ramaphosa added that government is already investing in strengthening public healthcare through infrastructure upgrades, expanding community health programmes, and improving access to medicines.
At the core of these efforts, he said, are healthcare workers who continue to serve under pressure.
“We owe it to every healthcare worker to give them the support, tools and working conditions they need to do their vital work,” he said.
The president concluded by reaffirming the government’s commitment to ensuring that “equal access to quality healthcare must be the standard we set and the constitutional promise that we keep.”
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