This report from the South African Institute of Race Relations lays bare the appalling scale of deficiency, mismanagement, negligence and corruption in the public health sector which the government intends to be the core of its proposed National Health Insurance (NHI) system.
The South African government wants to implement a policy of National Health Insurance (NHI) to ensure that every South African has decent healthcare. Although this is a noble goal, it is unlikely that the government will be able to make this a reality. All South Africans will be compelled to belong to the NHI system, without the right to opt out. At the same time, people will have to pay into the system even if they choose to pay contributions to a medical aid, too.
All health revenues will be paid into a central fund, from which all health disbursements will be paid. The state will decide on all aspects of healthcare, and private healthcare will effectively have been nationalised, with all that that entails. The South African government has shown itself to be poor at running a wide range of entities, from South African Airways (SAA) and Eskom to the education system – the list is long – and there is no reason to think it will manage to run the entire healthcare system eff ectively. The NHI will have serious consequences for medical aids and for individuals. Medical schemes will only be allowed to provide ‘complementary cover’. In the long term, all medical aid schemes will likely cease to exist. Few individuals will be able to afford medical aid on top of the increased taxes that they will have to pay to help fund NHI.
Most people will be forced to rely on government healthcare.This is not what the government should be doing – rather than trying to reduce private healthcare,the government should be looking to increase access to it. Throwing more money at the country’s profoundly deficient public health system and effectively nationalizing private healthcare will not improve health outcomes. South Africa needs to be innovative in working to provide quality healthcare for all,but disabling excellence in the private healthcare system will not be the answer.