In 2011, the South African health minister, proposed a national health insurance (NHI) for South Africa with the aim to deliver universal health access and care to all South African residential citizens, with a single fund to cover all people, no matter their income. The first five year period was reached at the end of year 2017-2018. In this peer reviewed paper, the authors compare and contrast the proposed NHI financing reforms against what has been implemented in reality to date.