Is it time for Namibia to introduce a national insurance tax?

Considerations
Prime Shaapopi
  • 22 Hours Ago
As Namibia charts its path toward a more just and equitable society, one urgent question arises: should the country introduce a National Insurance Tax to fund universal healthcare for all citizens?

This should not be framed solely as an economic or fiscal debate. Rather, it is a deeper question about the kind of Namibia we want to build.

Who deserves access to healthcare? How do we sustainably finance a health system that leaves no one behind, including healthcare workers who often operate under severe resource constraints? And, perhaps most importantly, how do we ensure all healthcare professionals are employed without straining the national budget?

Since independence, Namibia has made notable progress in healthcare. The government spends approximately 9% of gross domestic product on health – among the highest in Sub-Saharan Africa – demonstrating a strong commitment to public health. Public hospitals and clinics now reach many remote communities, yet stark inequalities remain. Rural areas often suffer from staff shortages, outdated equipment and unreliable access to medicine. Meanwhile, private healthcare, though world-class, is accessible only to a privileged few. For many Namibians, a serious illness can result in financial catastrophe, especially as out-of-pocket spending remains alarmingly high.

Even the most basic and universal medical needs, such as childbirth, have become increasingly unaffordable for many families. Bringing new life into the world, once considered a deeply communal and accessible experience, now carries a heavy financial burden. Costs for maternal care, hospital stays and delivery continue to rise, often pushing families into debt. This undermines the principle of equitable healthcare and raises serious questions about how society values the health and dignity of its people, particularly women and children.

The Covid-19 pandemic exposed deep vulnerabilities in the system, stretching it to breaking point and highlighting inefficiencies and unequal access. Health emergencies do not discriminate by income or geography, making universal coverage more urgent than ever. Across the country, thousands still die from preventable diseases, and the rise of non-communicable conditions such as cancer, diabetes and hypertension demands structured, long-term care models.

A National Insurance Tax is a dedicated, ring-fenced social contribution, usually paid by both employees and employers, to fund healthcare for all. It is not merely a tax; it is a solidarity mechanism, a social contract that says, “Your health is my concern.”

For Namibia, this could mark a shift toward inclusive growth, making healthcare a right rather than a privilege. It would reduce reliance on out-of-pocket payments, the most regressive form of health financing, and create a resilient healthcare fund rather than relying on volatile donor aid or shifting budget allocations.

Healthy populations underpin strong economies. A system that ensures early diagnosis, treatment and preventive care can reduce absenteeism, improve productivity, and avoid costly late-stage interventions. Moreover, if citizens see their contributions directly funding quality healthcare, it could help rebuild public trust in government institutions – a critical need for Namibia and many other African nations.

* Prime Shaapopi is a chartered accountant and writes in a personal capacity.**