It is envisioned that the planned National Health Insurance (NHI) will see the rich pay for the poor and the healthy for the sick when it comes to healthcare in this country.
The NHI is looming like the proverbial monster in the cupboard. No matter how you spin the concept, you just feel this is another huge disaster waiting to happen, like the E-toll system.
There are many issues to ponder regarding the NHI, and it boils down to practical implementation and the overburdening of those who are already overburdened.
To recap, the NHI is a health financing system that pools funds to provide access to quality health services for all South Africans based on their health needs and irrespective of their socio-economic status.
This health insurance will cover every South African, employed or unemployed, earning a low income or high income.
It is proposed that the NHI will offer all South Africans and legal residents access to a defined package of comprehensive health services and it is committed to offering a wide range of services as possible.
According to the government, the NHI will be funded by the rich and the middle class, who will be contributing to the NHI to support the poor who cannot afford healthcare.
So, let us stop the bus right there, if the bus has even moved at all with all the strikes.
At this moment in time, the rich and the middle class are already being taxed almost to death to take care of the poor in this country. Remember, there are around 17 million citizens living on social grants, while the unemployment rate stands at around 27 per cent.
The government is, therefore, proposing to add an even greater burden upon the rich and the middle class to help the poor. Even though this is a noble concept, the reasoning behind the NHI is flawed, because it now becomes the burden of the citizens to provide healthcare where the government has failed to do so.
After all, South Africa has state hospitals. These hospitals provide affordable healthcare. Problem is, the service at these hospitals are atrocious, which is forcing a proposed massive reorganisation of the current health system, both public and private.
State hospitals were never supposed to be providing poor healthcare affordably. It is supposed to provide healthcare of the highest standards for those who cannot afford medical aid, but this is not happening.
What will happen is that the rich and the middle class will become so overburdened that many might just leave the country, or pump less money into the economy.
This will cause the economy to come to a screeching halt, causing a greater strain on government due to a loss of investor confidence, and as the funds become less more South Africans will struggle to survive.
And so the vicious circle continues to bleed those dry who are willing to work.
Agreed, healthcare is a human right. And yes, medical aid is very expensive. Studies show that only around 15 per cent of the population can even afford medical aid or a hospital plan.
Personally, I should be applauding the NHI, because for myself and my family medical aid is too expensive an option. But still, how plausible is the NHI? Remember, the government has also stuck its head into the hornet’s nest with its promise of providing free education.
Where is all this money supposedly going to come from? Taxes? You can only bleed so much from a rock, as the middle class is drowning in debt already.
In the meantime, the NHI has already been met with resistance, as capped doctors’ fees to be imposed by the national health insurance legislation could see a mass exodus of doctors from the system.
This after the South African Private Practitioner’s Forum announced its members would opt out of the NHI, threatening legal action should they be forced to work at fixed rates.
Doctors who were not willing to comply with new capped fees would result in them not being accredited by the NHI.
It is currently understood that patients will go to NHI-accredited doctors and the NHI fund will pay those doctors [similar to the way private medical aids currently remunerate doctors].
All of this drama is unfolding in the wake of South Africa already sitting with a shortage of healthcare practitioners. According to the World Health Organisation (WHO), there was less than one physician per 1 000 members of the population in South Africa and other sub-Saharan countries.
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