Solidarity has sharply rejected proposals by the Department of Health and National Treasury to use medical aid tax credits to raise funds for the National Health Insurance (NHI) scheme. The plan under discussion would see about R34 billion raised by removing or reducing the credits currently claimed by medical aid members.

These medical aid tax credits are rebates that reduce the amount of tax people pay based on their medical aid contributions, designed to ease the burden on households that fund private healthcare rather than relying entirely on the public system. This week, NHI deputy director general Dr Nicholas Crisp told the media that removing the credits would prevent double funding once NHI pays for services and that the department is working with Treasury on phasing them out.

Theuns du Buisson, a researcher at Solidarity, said that medical aid members were being unfairly stripped of funds: “that rightfully belongs to them, precisely because they do not burden the public healthcare system.” He said the announcements are: “completely premature and unfair,” especially given that medical aid credits currently enable members to reclaim tax relief since they make less use of public health services.

Solidarity said there was a contradiction in the government’s behaviour, pointing out that while the state has asked courts to suspend legal proceedings on the constitutionality of NHI pending another case, it continues pushing ahead with implementation planning. The trade union warned that medical aid members are effectively being forced to subsidise NHI twice, through their tax payments and higher medical aid costs, while they receive no direct benefit until the system is live.

If the government proceeds with NHI, Solidarity said, it would be a violation of property rights and fairness, penalising those already investing in their own healthcare.