NEWS & ANALYSIS

NHI: Continued pressure by civil society important – Solidarity

DoH must investigate alternative proposals rather than try to save this disturbing policy

NHI: Continued pressure by civil society important

Solidarity’s Occupational Guild for Health Practitioners encouraged civil society today to continue to apply pressure from all spheres on the controversial NHI Bill. This follows after the Cabinet rejected the current Bill on National Health Insurance (NHI) earlier.

According to Morné Malan, senior researcher at the Solidarity Research Institute, the pressure that was applied against the Bill by the Occupational Guild, as well as other civil institutions was decisive enough to temporarily derail the unworkable nationalisation of health care proposed by the Bill. “However, it is not the final nail in the NHI coffin. It is necessary to maintain pressure to ensure that discussions regarding health care are driven by the search for the best outcome for the greatest number of citizens rather than awarding civil servants with ideological accolades.

Malan emphasised that the Department of Health must investigate alternative proposals rather than trying to save this very disturbing policy which, at its best, is not feasible. “Many – more effective and feasible – alternatives have already been placed on the table during discussions with the Department, but these alternatives have not been considered.

The Department’s tendency, during this round of participation, was to argue that if you do not support the nationalisation of health care, you are actually against more accessible services. That is obviously a crazy argument and we hope that this process will go back to the drawing board, and that commentary by experts from the fields of economics, law, politics, and especially representatives from the health care industry, who will be influenced the most by the Bill, will be considered more carefully,” Malan said.

Earlier this year, the Solidarity Occupational Guild for Health Care Practitioners hosted a crisis summit with leading experts in the abovementioned fields, where excellent options towards solving the health care ailments in South Africa were discussed.

“It was painfully clear from the start that the NHI Bill would never be able to fulfil its promises. The Bill is not only financially and economically unfeasible but is also not practically capable of implementation. The nationalisation, as the Bill had proposed, did not represent an incremental improvement in health care, but rather a drastic decline. It is not the worst among good options, it is just bad.  The NHI would have lead to a poorer and sicker country, “ Malan said.

Malan explained that to solve the health care problems in South Africa, the Department will have to drastically revise its attitude towards private service providers. “We currently have a world-class private medical industry and one of the weakest state health care systems in the world. Therefore, the solution cannot be that the former is swallowed by the latter.

The question is how to render the services of the private sector more accessible and affordable for all South Africans and there are already answers to this question, for example a coupon system. The Department will have to be more pragmatic and less ideological about the policy and they should ask what would bring about the best impact, on nett, on the health of South Africans. We all want to live in a healthier country and need creative and innovative ideas – not adaptations of a bad policy which has already failed throughout the world,” Malan concluded. 

Issued by Morné Malan, Senior Researcher: Solidarity Research Institute, 7 December 2018