NHI will prove disastrous for South Africa - DA

The National Health Insurance Plan: Why the DA opposes it

If the proposals in the leaked ANC Task Team Report on National Health Insurance (NHI) are implemented, both the quality of healthcare and the economy will suffer.

As always, the poor will be hardest hit, because the NHI does nothing to address the crisis in public healthcare. That crisis has been caused by a shortage of nurses and doctors, inadequate facilities and resources, and weak management systems. The poor bear the brunt of it.

The NHI is not pro-poor. In fact it is anti-poor. It is a sure-fire recipe for the destruction of public healthcare.

The DA recognises that the poor in South Africa get poor service from the health system. Health care in the public sector is affordable but of dismal quality, leaving patients queuing for hours for rushed and inadequate care, or no care at all. Quality health care in the private sector is available to a few, but at a high cost. The potential exists to bring these two sectors together to build a system that suits everyone's needs, and provides quality care to all.

However, the NHI plan the ANC is attempting to push through will not do this. The ANC is attempting to force through, with a highly selective consultation process and a preconceived agenda, a plan which makes no attempt to address the real problems of health care, while adding a massively expensive and cumbersome layer of bureaucracy to a system which is already unstable.

The DA believes that we must fix the problems of the health system on the ground, and that we can do this easily and without massive expenditure on more bureaucracy. We have a system that can work, provided that some basic principles are followed - and these principles would apply to any system we decided to implement. We will fight in every way we can to ensure that ordinary South Africans do not bear the brunt of another ANC spending extravaganza which makes big promises and delivers little.

Process: Secrecy, rushing and selective consultation

The NHI has enormous implications for every single South African, including those who are not within the narrow circle of the ANC and its alliance partners. Yet the process around developing the plan has been shrouded in secrecy from the beginning and has embraced only like-minded interest groups. An ANC document titled "The National Health Insurance Plan for South Africa", prepared by the party's NHI task team and dated 16 February 2009, was yesterday leaked to the media, but would otherwise not have been made public. This is part of a pattern which has been in evidence ever since this matter was placed on the ANC's agenda, several years ago. 

It has been made clear from the outset that the NHI will be presented as a fait accompli to the public, once the ANC has decided on the details. This is indicated, for example, by an ANC press statement released this week asserting that "the ANC is currently allowing internal processes on the NHI to be concluded before a formal public statement is released on the matter".

The ANC task team headed by the former director-general of health, Dr Olive Shisana, is dominated by trade unionists, including Nehawu head Teboho Phadu, and they have made it quite clear that they are pursuing a particular agenda, which is driving the process and determining the outcomes. The dismissal of opposing opinions as those of "narrow interest groups and individuals bent on undermining the introduction of NHI" makes it clear that the ANC is not interested in any real consultation.

It seems, furthermore, that there is every intention to rush this plan into operation despite any objections. ANC secretary-general Gwede Mantashe, speaking on behalf of the ANC national executive committee recently, stated that "the National Health Insurance must be in place within the first year of [the current] term". Timetables in the leaked report suggest that legislation will be drafted within the next nine months.

It is widely reported that former health minister Barbara Hogan's insistence that the NHI proposal be subjected to proper processes and public scrutiny led to pressure from the unions that she be removed from the health portfolio.

Now that the proposals are reaching the legislative stage, the ANC's lack of consultation is running into problems even with its own checks and balances. The DA has been informed that three pieces of legislation published in the Government Gazette on 2 June, and which start to lay the foundation for the NHI, have not passed through parliament's Joint Tagging mechanism, because the bills have not undergone a public consultation process as required. (These bills are the Medical Schemes Amendment Bill, the National Health Amendment Bill and the Medicines and Related Substances Amendment Bill.)

Not only is this process fundamentally undemocratic, but it is also a recipe for bad policy. If the only opinions being seriously considered are those who are already ideologically committed to the idea, then the outcome cannot possibly be as rigorously tested as it would be with more critical voices.

Content: Massive expenditure, disastrous outcomes

The NHI will come at an enormous cost to South Africa; estimates put the cost at an extra R100 billion a year, amounting to a 40% increase in the health budget.

This will come from additional taxes. Calculations emerging from the health department suggest that raising the amount required will require taking an additional 9% of current gross household remuneration from every family. However, the question of the consequences of the enormous additional burden on the tax base does not appear to be of great concern to the ANC. According to new health minister Aaron Motsoaledi, speaking to the SABC recently, it is simply a case of "those who earn more will pay more". The implication of this is that the ANC understands there to be a limitless source of income from the already overburdened taxpayers.

Particularly in the current economic crisis, this assumption is dangerous and potentially catastrophic. It may well spiral South Africa's already precarious economy into free fall, as higher tax burdens cut jobs, reduce expenditure on South African products, and increase immigration as skilled workers flee the likelihood of being forced into a low quality public health sector and denied the services they now have.

Instead of improving the quality of health care for all, it will merely decimate the current capacity in the system and leave the poor worse off than they already are.

But these consequences do not seem to have formed part of the planning around the NHI.

At the same time, what is also notable about the information available to us is how little attention has been placed on the current problems facing the health system. The assumption is made that more money will solve all problems. But in fact, the problems of the health system are not primarily about money, but performance. Critical problems such as bureaucratic mismanagement can be addressed without increased expenditure, and would result in far more efficient use of available money and a much higher quality of care.

The DA's alternatives

South Africa has a health system has many qualities which could be improved and developed. We do not need to start again from scratch. The government holds in its hands the means to make this system work for all without using money which could be better spent on doctors' salaries, social grants or housing.

In particular, the DA proposes:

• A comprehensive review of the qualifications and experience of hospital managers. It is not acceptable that we have situations where the management of hospitals is handed over, for example, to ANC councillors with degrees in politics. Managing a hospital is highly specialised and requires people with specific training and experience. The report that the DA finally managed to obtain into the astonishing number of baby deaths in Ukhahlamba in the Eastern Cape last year pointed not to a lack of money, but to the simple failure to follow basic procedures, to monitor patients, and to provide the most basic medication.
• A review of the structure which governs hospitals. Where there are good hospital managers, they are severely constrained by an antiquated management structure. This structure requires them, for example, to obtain approval from the MEC for senior hospital appointments - which often takes months. They are also not entitled to retain the fees they collect, which means there is no incentive to do so and millions of rands go uncollected. Good managers must be given the authority they need to manage their hospitals.
• Improve quality management. The National Health Act makes provision for many innovations that would make quality management in the public sector much more viable. But many of these have simply not been implemented, including one for the establishment of an Office of Standards Compliance. All hospitals need to be monitored on a regular basis to determine how well they are meeting specific quality standards.
• A change in the attitude towards the private sector. The private sector offers enormous potential to improve the quality of the public sector, and it has offered its services in many different areas in this regard in various areas. These offers have largely been ignored.

Conclusion

The DA will not accept the unilateral imposition of a policy which heralds only further decline for the health system at enormous expense. We will be taking the following steps in the short term:

• Requesting that the health committee schedule a series of meetings to discuss this question, and that the minister of health be requested to attend such a meeting to explain the NHI. 
• Scheduling meetings with various other groups who have raised concerns about the process and the substance of this scheme, and where possible work with them. 
• Ensuring that parliamentary requirements for the processing of various pieces of legislation that form part of the NHI are followed rigorously. In particular:
  • Ensure that proper public consultation is undertaken. 
  • Ensure that all legislation introduced is accompanied by a clear, comprehensive costing report, as required.  

• Asking questions in parliament about the details of the scheme, the members of the committee and any possible conflict of interest involved.
• Finally, exploring legal avenues to take this matter further. For example, legal precedent makes it clear that consultation on legislation must be thorough and meaningful. But the process followed so far suggests that the ANC has no intention of engaging in substantial consultation.

Statement issued by Mike Waters MP, Democratic Alliance shadow minister of health, June 10 2009

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According to new health minister Aaron Motsoaledi, speaking to the SABC recently, it is simply a case of "those who earn more will pay more". The implication of this is that the ANC understands there to be a limitless source of income from the already overburdened taxpayers. Particularly in the current economic crisis, this assumption is dangerous and potentially catastrophic. It may well spiral South Africa's already precarious economy into free fall, as higher tax burdens cut jobs, reduce expenditure on South African products, and increase immigration as skilled workers flee the likelihood of being forced into a low quality public health sector and denied the services they now have."

Mike Waters

 

Related links

Articles:

NEHAWU backs introduction of NHI »

SACP to defend and hasten implementation of NHI »

NHI: ANC won't be deterred by narrow interest groups »

ANC must end secrecy over NHI - DA »

Comments

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responses to this article

what to do as a concerned citizen, is there actually anything we can do? if the ANC decides to go ahead with this idiotic idea (probably the top of the pile in their idiots guide to running a country into the ground), what / who can stop them??? by bob on June 10 2009, 14:57 Find this comment inappropriate? Report it

NHI If the ANC planned it, it will be a failure, if the ANC implement it, it will be a disaster. by Petr on June 10 2009, 16:40 Find this comment inappropriate? Report it

Why is the ANC so confident? Under impossible financial circumstances, the ANC - promises a NHS 500 000 jobs houses ... Manuel and the other cautious men of money knwo about this and are not protesting. This can tell us only one thing - money, . .more lots of it, has been promised. The Chinese have gone shopping for small countries with greedy and stupid leaders. I live behind a small state hospital. A few weeks ago we had a plague of Flies of Mosaic proportions. Turns out they came from the hospital. I can't recall whether the flies were the first plague visited upon Egypt, but I'm getting ready for the others. . .less by Sgmdge Neelsie on June 11 2009, 02:43 Find this comment inappropriate? Report it

The NHI will work. Do not be discouraged by the Waters of this world. Who is he? He is a prophet of doom. You were wrong before by thinking things must be plannned by white people to succeed. You are wrong now to believe that again, because blacks planned it, it will . .more fail. Vusi . .less by Vusumuzi Hlatshwayo on June 11 2009, 08:28 Find this comment inappropriate? Report it

If the NHI were a DA idea... It's a very good plan but perhaps it should be implemented on civil servants for the time being. The main issue is when this plan goes ahead, private medical aid companies are going to be killed, that is jobs and innovation down the drain. However, the . .more good thing about this debate is hopefully, companies like Discovery may wake up and realise there are other people in this country who deserve decent access to health and not just the rich. . .less by Netshitenzhe on June 11 2009, 09:45 Find this comment inappropriate? Report it

Singapore has a pretty good system A portion of your tax goes into a fund - this fund pays for YOUR future social welfare - if you don't use it then it can be inherited by your next of kin. If you need more than you have in there, then you go into debt but when you work again you will pay . .more it back. I am a bit vague about the exact details but the concept seemed pretty good. Basically your money goes into your own future social welfare assistance if hard times come. Might be worth looking at. I don't see how the 5 million taxpayers can fund a comprehensive free health service. An average family already needs to find R 2000 just to have a simple hospital plan for serious emergencies. Add on doctors visits and your average family is probably already paying about R 40,000 a year on their own medical needs. . .less by Sad days on June 11 2009, 10:15 Find this comment inappropriate? Report it

NHI and ignorance Once again Domza et al are displaying their most amazing ignorance, or is it that they just will not see how they are being deceived by ANC politicians, or is it that they are part of the problem? Anybody with any sense or just a wee bit of brains, can . .more see through the ANC plan. But because they have this weird idea that the DA represents white people and the rights of white people only they will never concede that the DA might just be, and most probably are, correct. Slowly but surely the domza's (dom as in dumb, za as in South Africa) of this country must and will see how stupid they have been to once again entrust the government of this country to deceiving, corrupt, lawless and plain stupid people. . .less by Sojourner on June 11 2009, 10:24 Find this comment inappropriate? Report it

Domza I tell you what is disgusting Domza,the total distruction of public health care despite the vast amount of money throw at it.WHITE middle class is struggling to keep up with the amount of money it has to dish out just to survive.What privilege?The . .more pivilege to pay for the theft and incompentence that is so rife in this govt.Everyone wants to see a successful public health system.Everyone wants an efficient govt for all and you sir are a liar and a fraud to suggest otherwise.People like you thrive on fear mongering and separation of groupings to gain power.Your filth has Never delivered ANYTHING to a single people that has had the misfortune of being enslaved by your sort. . .less by Noddy on June 11 2009, 10:28 Find this comment inappropriate? Report it

WAKE UP MIKE IT WAS SELF CREATED NIGHTMARE SINCE 1948 Mike is talking like a he had a terrible nightmare. The specialists working in Private facilities also work in public. Government subsidizes both public and private healthcare any way but DA cannot hold RSA at ransom when public healthcare needs to be . .more improved. That is why Dr. Letlape was replaced by SAMA as chairperson because he denounced his medical aid. Loose your job you will realize how much you will need good public health. UK has contracted Nectcare and Netcare is making a killing there! Is Netcare not surviving on NHI in UK? Wake up Mike and address real issues not creative fears of DA. Every constituency of DA still has public and private priviledges since 1948. ANC is accountable to the poor, Not DA. The poor cannot afford the cost of private quality Mike is enjoying. You have become outdated. All those emmigrating, go to UK or Australian NHI's but not RSA NHI. Mike you are lossing sight of future politics. Fear of 1948 RSA is still in your head. This is 2009 and swart gevaar has not been realized still. Support your governement for your own good. Unless you start a campaign to get Whites to move into black townships, I will never vote for DA as the fear is unwarranted!!! . .less by MAZOZOMAMATLEPA on June 11 2009, 10:29 Find this comment inappropriate? Report it

@Sad Days The R2000 is based on Discovery and other horrendously over-priced madical aid schemes. If you do your maths, at an average of R600 per month for 14 million taxpayers - that is 100 billion rand a year which is the figure people they have put out. I . .more repeat, the plan is certainly workable but govt. doesn't necessarily have to own all of it. . .less by Netshitenzhe on June 11 2009, 10:32 Find this comment inappropriate? Report it

At Vusumuzi Hlatshwayo It's such a pity that there isn't informed (and adult) debate on this NHI thing. When Vusumuzi rejects Waters' issues with the proposed NHI system , it's not because his points raised are deemed (and argued? not.) incorrect, but because he is white. This . .more is blind prejudice and something very evident iin SA today. Unless we learn to debate The Issues (rather that tagging the debaters), SA's sunk. Play the ball - NOT the man, Vusumuzi. Try it. . .less by Simon on June 11 2009, 10:53 Find this comment inappropriate? Report it

@Domza You have really excelled yourself today in making a statement which can at best be described as 'stupid'. It may be difficult, but try to judge a case/argument on its merits rather than by whom it was made. by Nic on June 11 2009, 10:54 Find this comment inappropriate? Report it

Domza If you think the average South African family enjoys dishing out a large portion of what they earn just to ensure they can have some sort of decent health care you are not just stupid,you are fool! by Noddy on June 11 2009, 10:59 Find this comment inappropriate? Report it

@Vusi - Sad days The numbers are the scary part. Taking 9% of current renumeration. but it won't be aimed at the poor since there are many more lower end tax payers than on the higher end they would probably have to charge about 20% aditional on current tax payments on . .more the rich, that means the rich will go from giving 40% of their income to government to 60 od percent - so for a reasonably well of person earning 400 K a year would need to pay aditional 80 K for the rest of the countries hospital charges but don't believe for a second it will take 1 or 2 years to upgrade the current government hospitals so he will still pay his private health care bills also which will also need aditional funding due too loss of lower end members. These guys will leave mark my words.. When all the so called evil rich guys has left this country will know how Zim got to where it is today. It is bad economic practise to throw money at a management problem - sort out the management easy as that. As bad as apartheid was these hospitals ran well with a lot less money than what is advised now regardless that it was for a privileged few, it was well managed, that is what needs to be fixed. . .less by aajj on June 11 2009, 11:14 Find this comment inappropriate? Report it

ANOTHER EXAMPLE Show me where things work in Africa. I rest my case by PIE IN THE SKY on June 11 2009, 11:30 Find this comment inappropriate? Report it

MIKE and NHI Congratulations Mike! Rational , analyticsl and independent thinkers are diminishing in the political circles. Apartheid is now wearing a black skin. It does not matter what good thing you say, so long as you are white it will be condemned, so long as you . .more are not ANC it is foolishness. The wise people eschew evil and fools are not rebukable. Spread the knowledge Mike, some ears will listen and when a disastor worse than HIV/AIDS strike we will not make Mbeki a scapegoat anymore. . .less by sedika on June 11 2009, 11:52 Find this comment inappropriate? Report it

@Netshitenzhe The last stats Sars has is that there are 5.3 million registered tax payers. http://www.sars.gov.za/home.asp?pid=44114 also keep in mind that this will not be billed equally there will be a big bracket of taxpayers that will not have to pay for it or pay . .more a lesser percentage. And comparing 2000 for private care to state hospital is a futile exersice - nobody that can afford private care opts for state hospital - I wonder if the health minister would even go to a state hospital. . .less by aajj on June 11 2009, 12:00 Find this comment inappropriate? Report it

Also disgusted Domza, stick your comment where the sun don't shine! I don't care what you and that bunch of idiots you support think. Just please include me out and don't expect me to pay for it. The problem with the ANC is that they don't seem to realise . .more that a free society is a dynamic thing. Actions beget reactions. People are not sheep who will meekly accept a material degradation in their wellbeing as is being proposed. They will act to look after their own best interests. There is no way anyone will volunteer to pay more money for demonstrably worse service. The only way to achieve this is through coersion and then we are no longer free, but subject to tyrany. Those that can leave will, leaving those that can't to suffer the consequences of their leaders' shortsighted folly. That dear Domza is why your commie heros built walls around their countries. To keep the people in, not to keep us from flooding in. . .less by Julius on June 11 2009, 12:10 Find this comment inappropriate? Report it

Disgusting The DA white led middle class are the ones who pay the bills for the rest of you clowns, so I would stop complaining. Although you will probably be find out what it will be like without us if this idiotic plan is implemented. by Joe on June 11 2009, 12:16 Find this comment inappropriate? Report it

Domza Rarely am I enraged at commentry on this sight but the S.A. Communist party making the white middle class the 'new' Kulaks of S.A. is despicable.Don't worry Domza,if the situation here ever gets to be on par with that part of Russian history, I will look . .more you up,if you aren't already back in the U.K., despicable coward. . .less by Noddy on June 11 2009, 12:46 Find this comment inappropriate? Report it

@DOMZA Ask Zimbabweans how well it works to just take from the rich and give to the poor. I'm all for paying for a better health care system for the poor but don't ask me to throw my money at the current structure and mangement. Fix the real problem then ad . .more money. Government can't even manage to pay the current doctors what they promised - how about fixing that, how about paying supliers that threatened to stop suplying baby formula which meant kids with HIV positive mothers could become infected. These problems require proper management not 100 billion rand. Appart from even rich people are losing their homes and taking strain - if you ad this tax burden even more will be sitting next to you asking for free healthcare and homes. Do you think this will leave anybody in a better position? . .less by aajj on June 11 2009, 13:00 Find this comment inappropriate? Report it

conscientious objector If as a Christain Scientist I do not partake of any health system or medical aid scheme as I do not believe in medical interventions because the Lord will provide, will I still be required to pay for the proposed NHI? by healthy on June 11 2009, 14:00 Find this comment inappropriate? Report it

traditional healers and NHI There is possibly another ulterior purpose to this scheme. Will traditional healers be included in this NHI package? This will then bring them into the formal sector with decent jobs! by sangoma on June 11 2009, 14:03 Find this comment inappropriate? Report it

WHAT CAN BE MORE DISASTROUS THAN APARTHEID H WHAT CAN BE MORE DISASTROUS THAN APARTHEID HEALTH SYSTEM FOR us Africans. Who are trying to fool helen godzille and your boyfriends. by Coolcat on June 11 2009, 14:18 Find this comment inappropriate? Report it

Mamatlepa and Netshitenzhe You both hit it on the nail. The fact of the metter is that these Med Aid Schemes are making a killer out of people. The Government's plan for NHI will not only benefit blacks even though they are the majority who go to public hospitals for service but, . .more the whites as well. Next is education both higher and lower. . .less by Non Aligned on June 11 2009, 14:47 Find this comment inappropriate? Report it

NHI - in countries where this has been implemented it is not working (Canada claims that it only works well because they can access specialised services across the border in the US). - the gap between taxpayers and the unemployed / pensioned etc is . .more wider in SA than any country where this has been [unsuccessfully] implemented - preposterous proposed solution - expect then that those drafting it will be happy to go through the public health care system (or pay out of their pockets to receive private care) - NOT LIKELY - giving access to another pot of money to one of the most corrupt countries - well there are no words - contributions should be for everyone earning an income, including in the informal sector. any income should be declared and taxed, no matter how small the amount. if the tax rebates are going to be removed for medical, this should be implemented as an additional measure. why should those in the formal sector be fully responsible? taxi drivers included. - CUBAN DOCTORS? - agreed that there is a significant imbalance and that it should be addressed, this is however an outrageous proposition and to see that the research is being funded by the Bill and Melinda Gates foundation is curious. . .less by M on June 11 2009, 15:01 Find this comment inappropriate? Report it

@aajj Your point is half baked aajj. If you want to deal with a situation with the ultimate intention of making a holistic overhaul, you don't just deal with the structural defects (admin and management) but the attitudes(people and personalities) and context . .more (situation) collectively. The inequalities that we find in our society particularly in education and health systems have been left unattended for long. The time is NOW to start tackling them. I agree with Netshitenze though that maybe its implementation should commence with public servants and then roll out to other sectors. Also agree that it shouldn't be a Government monopoly but allow for those who can afford and maintain their luxurious life style to continue enriching the private health sector. . .less by Non Aligned on June 11 2009, 15:08 Find this comment inappropriate? Report it

For Netshitenzhe A basic hospital plan in a non profit making medical plan is about R500 per person per month. 40m people in SA so that is 240 billion needed annually just for those admitted to hospital. Divide by 5 million taxpayers and that is 48000 each a year . .more - ie 4000 a month. And that does not cover seeing a doctor at a clinic, prescriptions etc. That is just for major diseases needing hospitalisation. And even then, that doesn't cover the whole fees of specialists. The client has to pay extra to cover those. I just don't see how the numbers are going to fit. . .less by Sad Days on June 11 2009, 15:33 Find this comment inappropriate? Report it

NHI @Julius: "...include me out..." ???? How very opaque of you ... @Joe: "The DA white led middle class are the ones who pay the bills for the rest of you clowns..." ??? Enough said ... The NHI is workable. It . .more will be implemented no matter what you say. The ANC already has the (NHI) support from the ID, UDM and IFP, so the DA can go an poliish up their silverware and brasso at home if they're bored ... . .less by Moxster on June 11 2009, 15:33 Find this comment inappropriate? Report it

@Non Aligned Everybody supporting this plan is looking at some airy fairy idealisms, have a look at the details and the reality then get a solution don't go chasing some half baked ideology. You are big on ideas but short on solutions how should one deal with . .more attitudes and the situation? I bet R100 billion wont fix that you are saying the same thing I am with less facts a bit of the pot calling the kettle black? You didn't even answer one question. The health sector has money to pay providers yet they aren't paying them - look at this link and tell me money is the problem you don't give people that are mismanaging our infrastructure more money - that is just rewarding incompetence. http://www.health24.com/news/Health_care/1-918,51223.asp. It's been said before but I'll say it again - the real people that suffer through all of this is the poor. Coolcat you've already been fooled by the ANC that the DA wants to bring back apartheid so don't feel so smug. Helen Zille faught next to your brothers and sisters to end apartheid but once again don't worry about the facts that isn't as much fun as just slinging mud around. . .less by aajj on June 11 2009, 15:48 Find this comment inappropriate? Report it

@Non Aligned so fix the atitudes and context The door is open adress the inequalities get the state hospitals and education departments to do a proper job, you don't need to criple the economy to do this. The state is green with envy that the private sector can . .more actually deliver and they can't. Same with policestations having ADT as their security company. The bottom line is that until the structures are in place taking more money from the rich is not the answer, I sincerely hope for a better life for all south africans but this idea won't reach this goal, guaranteed. Like gravity economic principles are facts of life, you ignore either at your own peril. . .less by aajj on June 11 2009, 16:07 Find this comment inappropriate? Report it

@Moxster You think like a fool. And a fool and his money are easily parted. This is one self-employed DA voter who won't be paying so that you can enjoy free medical care. I have so many ways of avoiding this, it is quite laughable. You will . .more land up paying for my medical care. LOL. . .less by Helen's only boyfriend - hands off my girl Malema! on June 11 2009, 16:33 Find this comment inappropriate? Report it

Worrying The thing that scares the hell outta me is that these foreigners will be able to enjoy the benefits of the system just like local poor Safricans, just as they are now getting govt grants and access to schools, hospitals, etc. like the locals and all for . .more free. The influx of 'refugees' is already at mind-boggling levels. To think that a R100,000 operation will be dispensed to foreigners just beggars belief!!! . .less by Sad sack on June 11 2009, 16:47 Find this comment inappropriate? Report it

Helen's only boyfriend - hands off my girl Malema! Dude, whatever floats your boat. You have been avoiding paying tax, or at least circumventing it for years while being "self-emplyed", so doing it when the NHI is in practice should not be rocket science to you. Yes, I will be paying for your (and . .more many like you) medical care. I do not have problem with that I really don't. That, my "friend", is the point of the whole thing. So, go ahead, avoid it all you like, at least I know my principle of free medical health care for all will be enjoyed by everyone, even you. :-) . .less by Moxster on June 11 2009, 17:32 Find this comment inappropriate? Report it

The Commies are Coming If you think the NHI is workable dear Moxster, you are delusional. Personal and corporate tax rates of 60% will kill the tax bases and goodbye NHI. By the time that happens, the only functioning part of the healthcare service - the private sector - . .more will also have died courtesy of the new government. It's Economics 101, but unfortunately our new commie leaders missed that lesson. . .less by McCarthy on June 11 2009, 17:56 Find this comment inappropriate? Report it

we need to mobilize You can consult and have 1000 meetings, but experience has shown that if the ANC wants to push something through, it will! It is a dictatorial organization and because it controls parliament and soon the judiciary, it will push whatever it wants through . .more and will just give some lame excuse as to why it didn't need to follow proper proicedure, just like Mpshe did when he dropped charges against Zuma. The only small chance of stopping this calamity is street demonstrations, burning of tires and a lot of noise. Problem is that the middle class, whom this will affect the most, are not that vocal.. . .less by crazyed on June 11 2009, 19:24 Find this comment inappropriate? Report it

National Health and PENSION You all complain about what this medical will cost and the subsidizing of it. Soon, maybe even before the NHI there will also be the new national compulsory retirement plan. Imagine in 20 years claiming your pension from the state with its great service . .more and efficiency. Your money is as safe as UIF, RAF and municipal accounts . .less by Sucker on June 11 2009, 20:46 Find this comment inappropriate? Report it

Lord Beveridge was a Liberal NHI is as much common sense as communism. by Domza on June 11 2009, 22:54 Find this comment inappropriate? Report it

@Domza we finally aggree by aajj on June 12 2009, 03:13 Find this comment inappropriate? Report it

@aajj You obviously are not clever enough to see that Domza did not make that comment in a negative light ... Eish ! by Moxster on June 12 2009, 10:32 Find this comment inappropriate? Report it

@moxter and you aren't bring enough to see I was only Moxing him. by aajj on June 12 2009, 10:37 Find this comment inappropriate? Report it

@aajj I "aren't bring enough" ... ??? by Moxster on June 12 2009, 12:15 Find this comment inappropriate? Report it

Moxter figure it out :) by aajj on June 12 2009, 14:06 Find this comment inappropriate? Report it

Its the management not the plan or lack thereof Its not the idea of a NHI that is bad, its that the anc will run it into the ground and embezzle the funds that is disgusting. providing national health care for all is great if you run it efficiently. Public health could be great too, if the doctors were . .more trained if anc mp's weren't employed to manage hospitals they know nothing about if tenders went to the right vendor and not your wives business, if peggy and her mates didn't steal funds if if if. Nothing wrong with NHI just the thiefs who will ruin it like eskom, like saa, like the public health care, like just about every municipality in SA, fraud corruption and incompetence. The ANC always trying to reinvent the wheel the rest of the world have tried all these things look and learn for once, your ARROGANCE IS BLINDING. Tick tock the 20 year meltdown after independence is near... . .less by Frank Talk on June 17 2009, 21:37 Find this comment inappropriate? Report it

brain drain i was always undecided about leaving this country..the impending nhi debacle has convinced me..and i take my skills with me by medical doctor on June 21 2009, 20:23 Find this comment inappropriate? Report it

tjo!!! Italy france and uk among others are leading countries in health care are on nhi, their taxes are a bit higher but they seem to be doing great, coz their life expectency is twice ours....i work for discovery...it puts bread on my table but screw it coz . .more the health of all south african citizens is more important.....to hell with the medical doctor . .less by mosotho on July 16 2009, 22:18 Find this comment inappropriate? Report it

Can It, all of you. First of all, reading these comments is ridiculous. Personal vendettas being settled. Its commentary, meaning, comment on the issue, not each other's intellect or lack thereof. Second, this plan is bound to fail resulting in the destruction of . .more South Africa's private (and functioning) heath sector. There is no logic in forcing already overstretched taxpayers into paying higher amounts in order to support the majority of the country and decrease the quality of the service for the ones who are currently on existing medical schemes. And lastly, anyone who says those who complain should leave the country should pipe down for at least two of many reasons: SA cannot afford to lose a single person of working age and in a "democracy", people must be free to voice their opinions. . .less by Jackson Mallabsolollum on August 18 2009, 17:09 Find this comment inappropriate? Report it

@mosotho Italy france and the UK can afford nhi cos they have more proportionalty more people in work to pay for there nhi. I can not see how SA can afford this with the high proportion of unemployment, in short in SA there will be more people getting 'free' . .more health care than those 'paying' for it. Does not make economic sense?? What SA needs more than an nhi is job creation, as jobless ness is the creation of most of the evels in SA!!! The ANC is more concerned with wealth distributionthan than wealth creation as long as they continue on this path SA is doomed to fale!! . .less by ivan on September 03 2009, 12:39 Find this comment inappropriate? Report it

NHI funding Anyone knows that if the state runs something, it is done suboptimally and with next to no level of innovation. In the absence of a private health care sector, expect standards of health care to drop to antediluvian proportions. One must also look at . .more the costs: as some have done here. We are looking at a marginal tax rate (company and personal) of 50% and above. The politicians will demand a raise or exempt themselves, everyone else will lose their shirts, homes and health in the process and the poor will only be marginally better off, assuming that this massive cash injection is met with an improvement in hospital management, levels of service, availability of medication and basic health care provision (which is the only thing likely to improve). Couple this to the 6 million people who need AIDS treatment, and our refugee neighbours, one can see why we need a drastic action plan, but not this plan. Leaving aside the really democratic and commonsensical way the ANC has debated this wonderful piece of legislative innovation, the new NHI should made mandatory for all employees of the ANC state, from presidents to ministers and MPs, and DGs. Private medical aids for politicians should be abolished when this legislation is passed, and travelling to France for treatment at taxpayer expense is also verboten. No Mugabe moves here! . .less by Just in passing on September 16 2009, 11:49 Find this comment inappropriate? Report it

Crime syndicates One needs to eradicate the crime syndicates in the current public health service. This should free up 40% of the current health budget, which can be used to inprove the processes in Gov Hospitals. NHI merely gives more food to the syndicates by fizzpop on September 19 2009, 17:17 Find this comment inappropriate? Report it

Learning from History's lessons Great minds beseach us to learn from history. Humanity has not learned yet to prevent sudden compound termination of civil structures - we blunder right into it like a bunch of proverbial lemmings. Then we declare (like Robert Mugabe seems to declare) . .more that there is nothing wrong; all is well - and the sheep follow to new levels of debasement, then calmly say "It is progress". Then they live complacently in diminishment, satisfied, because they forgot what they used to have. All soaring civilizations before us, in time fell, fading into history, to pave the way for a newer one - ultimately just as intellectually foolish. Perhaps one appropriate certainty is that everything that goes up, must some time fall. All things that once had a beginning are certain to have an ending. It is time for our current global corrupt civilization to end; it will create a new beginning! Perhaps we should thank those who facilitate this fall; it will be the beginning of progress into heralding in a new civilization! . .less by Ray on November 10 2009, 11:43 Find this comment inappropriate? Report it

SICKO I Recomend that anyone who is against NHI watch the documentry Sicko by Micheal Moore it will change your prespective on the whole thing by Sanele Mthethwa on November 19 2009, 08:55 Find this comment inappropriate? Report it

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