Universal health care is a global movement, it is not South Africa moving on its own, Health Minister Zweli Mkhize told the portfolio committee on health on Thursday.
Presidential adviser on health Olive Shisana concurred. “It [universal health care] is a global issue, it is not a South African issue.”
She said countries like Canada, the Nordic countries, the UK, Taiwan and Spain have single-payer healthcare systems. “South Africa is not unique.”
Mkhize, Shisana and a large delegation from the Department of Health were briefing the committee on the National Health Insurance (NHI) Bill.
Mkhize said he often heard the NHI’s critics saying South Africa should have universal health care, just not now.
“All countries that instituted national health insurance are in a better economic state now than when they started.”
Mkhize acknowledged there was concern about South Africa’s economy.
“I think we have dilly-dallied long enough. We cannot afford not to implement the NHI.”
Another often-raised concern about the NHI was that it would create another state-owned enterprise and with that opportunities for large-scale corruption.
Again, Mkhize acknowledged this was a legitimate concern, against the backdrop of state capture.
He, however, said measures would be put in place to prevent this. Some of the NHI’s critics also charge that it will effectively nationalise healthcare in South Africa.
Mkhize said nationalisation meant taking over ownership, and this would not be the case with the NHI.
“It seems like a bit of politicking to me,” he added.
The NHI will provide the same benefits registered South Africans will receive to permanent residents and refugees, while asylum seekers and illegal migrants will only be covered for emergencies. The children of asylum seekers and illegal migrants will receive basic health services, though.
FF Plus MP Philip van Staden asked why “these people” would get health care.
Aquina Thulare, who works in President Cyril Ramaphosa’s NHI “war room”, said South Africa was a country governed by legislation, and the Refugees Act compelled the government to provide refugees with the same health care as South African citizens.
She added the Bill of Rights stated that no one should be refused emergency medical services. “Our Constitution is unequivocal about that.”
ANC MP Pumza Dyantyi said the NHI should be like fast-food outlet McDonald’s, in the sense that you know what you would get at what price, and it was the same everywhere.
This elicited an amused look from DA MP Siviwe Gwarube.
Shisana said this would indeed be the case with the NHI.
Mkhize said all health centres would be certified to ensure they provided services at a specific level.