The Centre for Social Sciences Research (CSSR) and the  Institute for Democracy, Citizenship and Public Policy in Africa  (IDCPPA) at the University of Cape Town invite you to join us for a lunchtime seminar on 3 November at 12:45pm. The seminar will be presented by Jesse Zhou.

About the Seminar:

State Fragmentation and the Self-Undermining of the National Health Insurance Bill (NHIB)

This presentation is based on my ongoing PhD research, which explores the discourses of stakeholders in the public hearing process for the National Health Insurance Bill (NHIB). It focuses on the analysis of discourses submitted by state parastatals, public entities and local government. The presentation addresses the sub-research question: How did the discourses of state entities, parastatals and local government on the NHIB reveal internal contradictions within the state that stem from the ANC’s ambiguity on redistribution?

My findings point to a variety of discourses across these stakeholders. Human rights-oriented Chapter Nine institutions broadly supported the Bill but criticised its exclusion of undocumented foreigners. The Competition Commission raised reservations about the Bill’s exemption from the Competition Act. Local government registered concerns, with the Western Cape Government stating a particularly politically charged opposition. Three of the most interesting outliers were the National Planning Commission’s opposition to the Bill, POLMED’s request that its own beneficiaries be exempted, and the NHLS’s proposal to be the designated pathology service once the NHIB comes into effect.

The presentation argues that even within the state itself, there is a lack of consensus on the NHIB, and the discourses reveal a number of self-interested institutions. This suggests the ANC’s ambiguity on redistribution is not only a feature of party positioning but is reproduced within the state apparatus itself.

Without a clear redistributive mandate, state entities interpreted the Bill through their own institutional interests, producing the fragmented state terrain that further complicates the NHI’s path from policy intent to implementation.

Speaker

Jesse Zhou is PhD researcher at the University of Cape Town, with a research focus exploring the discourses of the National Health Insurance Bill. My academic journey has spanned critical areas of health and social policy: my Master’s research examined the recruitment of foreign health professionals within South Africa’s immigration policy framework, while my Honours research explored the dynamics of domestic violence in same-sex relationships.

  3 November 2026
  12:45 - 14:00 SAST
  CSSR Seminar Room, 4.29, Robert Leslie Social Sciences Building, UCT

Hosted by the Centre for Social Science Research and the Institute for Democracy, Citizenship and Public Policy in Africa