NHI is a beautiful Utopian ideal, right up there with socialism

One thousand years: that’s how long it’ll take for South Africa’s National Health Insurance (NHI) to kick off according to a Wits University professor.

That’s how long I anticipate the queue for appointments to be too.

Yes, NHI is a beautiful idea, a Utopian ideal right up there with socialism and universal love.

But the route word of Utopia – a fictional island – is in the Greek for “no place”.

Utopia doesn’t exist.

Given that the real world is beset with graft, nepotism, greed and corruption – as whistle-blower Babita Deokaran would attest to, if she hadn’t been murdered – NHI might as well be a pot of free money left outside a casino.

And while we dreamers dream our Utopian dreams, the sticky-fingered are getting wet-lipped in anticipation.

After all, how many pairs of children’s skinny jeans would an entire NHI system require, how many R10 000 buckets, how many tons of R500/kg boerewors?

The Republic of Ireland has a public health service called the HSE, a bit like the UK’s NHS.

Here’s how it works: when I went to a public hospital emergency room, I paid €100 (about R2 000) at the door (I’m guessing the unconscious pay later).

I was triaged, and then I waited.

And waited.

Finally, 14 hours later, I went home with a clean bill of health, and a few months afterwards I was recalled for a heart scan just in case.

This was free on the state/ taxpayer.

Mine was an emergency that turned out not to be. The system worked.

The system also offers free cervical smears, vaccinations and so forth for all, regardless of income.

However, I also have private health insurance.

When I seek non-emergency medical treatment, I might end up in the same place as “public” non-paying patients with the same doctors, but my insurance pays, or I do.

As a “private” patient, I’m in a shorter queue for care.

I skip public health waiting lists – not quite 1 000 years, but maybe two or three – and the doctor gets to charge private rates and play golf and pay their mortgage and and, most importantly, stays in the system, providing a public health service propped up by a private one.

It’s not Utopia, it’s not fair, but it’s not broken.

And it’s never yet needed even one pair of skinny jeans.