South Africa is one step closer to implementing the controversial National Health Insurance (NHI) system, after the National Council of Provinces (NCOP) voted in favour of the NHI Bill on Wednesday. Eight of the nine provinces voted to approve the bill. The Western Cape voted against it. The bill, which has been in the parliamentary process since 2019, was pulled from the Order Paper last week when the NCOP chair, Amos Masondo, asked for a delay to consider a letter urging him to revisit the bill. The letter – written by Business Unity SA (BUSA) and Business4SA (B4SA) – expressed grave doubts that the NHI in its current form could be implemented or would be good for the country. Business says SA does not have the resources to implement the NHI, which would require raising an additional R200 billion in taxes. Organised business, the DA, and Solidarity. The DA and BUSA have said they will petition President Cyril Ramaphosa not to sign the bill and to refer it back to Parliament. Both argue that the bill is unconstitutional because Section 33 – which talks about phasing out the benefits for which medical schemes may reimburse members for – will limit access to healthcare rather than progressively expanding it. In this conversation, we speak about the bill and how it will affect the health sector with Deputy Director General of National Health Insurance at National Department of Health Dr Nicholas Crisp and Managing Director of the Board of Healthcare Funders of Southern Africa Dr Katlego Mothudi.