A VIEW OF THE WEEK: Dear President, SA healthcare is in ICU and NHI is no cure

Cries of pain filled the air in overcrowded and filthy hospital corridors as doctors and nurses rushed through an endless line of patients. Some had been there for hours, rumoured even days, too sick to move and pleading for help.

It is the scene that met a close family member on their recent visit to a public hospital and one that plays out daily in clinics across the country.

It is a reality that President Cyril Ramaphosa seemed to merely paint over in his combative speech while signing the National Health Insurance (NHI) Act this week.

The Act aims to provide free universal health care to all South Africans. It has been praised by some and criticised by others who claim it will collapse the private medical care industry and decline health services in the country. 

While there is no doubt universal healthcare is needed, the government has ignored warnings that the way it’s being implemented is bound to fail.

NHI a ‘success’ … just like ‘the end of load shedding’

Instead, it has closed its ears and labelled any critic a “doomsayer”. At the signing ceremony, Health Minister Joe Phaahla even compared the NHI’s future success to the “end of load shedding”.

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He expected applause for a president who “fixed” a power crisis, conveniently forgetting Ramaphosa sat in government and had oversight when corruption and neglect ravaged our electricity sector.

He got his applause- mostly from those who already have medical aid and refuse to use public health facilities. When these officials do, it is often in curated environments where they are told all is well and sold a fantasy of how the NHI will be the bandage to heal the system.

Address corruption first

Ramaphosa said the NHI was a “bold stride” towards a future where “no individual must bear an untenable financial burden while seeking medical attention”. Except, his government has created a climate for price-gorging, exploitive practices and a cost-of-living crisis that put an untenable financial burden on everyone, including those who currently have medical aid.

The “unsuitable and wholly unacceptable” state of SA’s healthcare system, as he called it, is largely the making of a government that allowed corruption to pillage health systems.

The NHI was presented as a decisive weapon in the war on equality, but the battle should be against corruption.

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Nearly 50 cases of corruption in the health system have been opened in just over a year, with countless others not discovered or reported. It has cost the system millions, probably billions, and yet Ramaphosa’s “boat we are all on” now seems to be heading in the wrong direction to achieve its aim.

He tried hard to allay fears that the NHI would fail. But his reassurances that the Bill of Rights and Constitution will protect all citizens fearing a collapse of the health system is worth little when it was not enough to protect us from a power crisis or a looming water disaster.

The NHI, as it was planned decades ago by freedom fighters, deserves to be a well-thought-out plan that will hold the corrupt accountable, while protecting and serving the most vulnerable.

Not the political football it has now become.

Like in football and at the signing ceremony, there will be cheers. But in our health system, they may soon turn to desperate cries for help in a hallway of horror.

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