Picture: Michel Bega
The continued looting of public funds in healthcare despite the pressures of the Covid-19 pandemic does not bode well for future support of National Health Insurance (NHI).
The hot-button Bill has raised debate again, following recent public statements for and against it in light of the pandemic.
According to Corruption Watch chief executive David Lewis, although the idea of a centralised health system isn’t necessarily a recipe for corruption, it can become a fertile ground if antigraft solutions are not incorporated into NHI policy.
This month, the portfolio committee on health in parliament continued holding public hearings on the NHI Bill.
The Bill has recently received its biggest endorsement yet with the Allied Health Professions Council of South Africa (HPCSA) proposing the Medical Schemes Act be entirely replaced by the proposed NHI.
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HPCSA president Professor Simon Nemutandani said in parliament the NHI wouldn’t work if there was more than one funding mechanism for health.
He controversially called for all assets that sit under medical schemes to be transferred to the NHI.
The Free Market Foundation (FMF) has lobbied fiercely against the NHI because the state would have absolute power over health resources, including medical scheme assets.
FMF deputy director Chris Hattingh said there was no good reason to believe the NHI would outperform the country’s other state-owned enterprises.
“Centralising the management of all healthcare in South Africa in the hands of the state, as the NHI would require, will not achieve better universal health coverage, especially not for indigent citizens,” said Hattingh.
“There are problems in the health sector, there is no denying it, but you’ve seen when people are in a pandemic, they still get together and try to help each other… The problem is when you try and centralise and put in too much state bureaucracy.”
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Lewis was less pessimistic about the prospects of the NHI in light of the levels of corruption seen during the pandemic.
“It was always going to be subject to corruption and the lesson to be learned from the looting of Covid-19 funds is that nothing is immune to corruption and unless we build the necessary mechanisms to combat corruption, the NHI funds will be very fertile ground for corruption.”
Dr Nkateko Mnisi, chair of the South African Medical Association Trade Union (SAMATU), said the medical fraternity had reservations about the NHI because of the uncertainties it posed for health professionals, especially doctors.
But, without a doubt, she adds the majority of South Africans needed it, as they were not properly served in the private sector and improvements had to be made in the public sector.
“The fraternity was [concerned] about how it was going to be rolled out correctly and how corruption was going to be prevented. It was not that people were against the NHI.
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“The NHI needs to happen. I’m from a province where 80% of the population uses the public services. Most can’t afford private healthcare. And even those who do, still end up on the public health system because of things like medical aid funds being exhausted.”
A recent report, released by the Financial Transparency Coalition, revealed that 63% of the Covid-19 recovery funds spent in developing countries have so far only benefited large corporations rather than going to welfare, small firms, or those working in the informal economy.
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