David Bullard writes on the ANC govt's plan to drop its NHI bomb on private healthcare
OUT TO LUNCH
I’m sure Dr Nicholas Crisp, the man responsible for getting the ANC’s latest populist baby, the National Health Insurance (NHI) scheme airborne, is a perfectly decent and well meaning bloke. I’ve no idea what he’s like as a doctor having never consulted him but as a financial whizz kid he appears to belong to the Jacob Zuma school of numerical fantasy.
Based on already outdated information the proposed introduction of free health care for all (NHI) would cost R256 billion to set up plus the obvious additional running costs. In a parliamentary portfolio committee meeting on health, the deputy director-general in charge of NHI at the Department of Health, Dr Nicholas Crisp, said, "government needs to spend as much on healthcare as it decides to".
This rather strongly suggests that Dr Crisp is either unaware that the country is almost broke and limping along with a junk status rating from every credit agency or that, like most members of the ANC, he believes in the existence of a magic money tree.
Indeed, his comment is the more terrifying because it completely ignores the need for any budgetary restraint and suggests that our well trusted politicians should spend whatever they feel like spending on healthcare with no limits imposed.
There are many perfectly valid objections to the proposed introduction of the introduction of an unlimited budget NHI, the chief among them being that this is probably one of the grandest (and maybe final) opportunities for the politically connected to help themselves to massive amounts of free money.
As we have already seen with the former Health Minister Dr Zweli ‘Sleazy’ Mkhize, having a medical qualification and taking an oath to ‘do no harm’ is no guarantee that the odd medical snout won’t find its way into the trough when there’s lots of taxpayer money sloshing around.
If Dr Crisp really believes that the R256 billion plus that is needed to set up this perfect system of public health care won’t be misdirected then I would respectfully suggest that he is living in LaLa Land.
There’s also the question of where all this money will come from. As the DA’s Shadow Minister for Health, Michele Clarke, has already pointed out:
The financial impact this Bill could have on the post-pandemic tax base, which grows smaller every day, is enormous. A third of the population is dependent on social grants. Only 9% of South Africans are contributing to 40% of South Africa’s total tax revenue. With no recent data to determine the impact that Covid-19 has had on the tax base, it is not difficult to see why funding the NHI from the fiscus will be difficult to achieve. South Africa’s national debt and unsustainably high budget deficit makes it extremely impossible to consider adding a new multi-billion rand expenditure item in the form of the NHI.
There may be no recent data to determine the impact that COVID has had on the tax base but it doesn’t take a financial genius to realize that COVID combined with the war in Ukraine may have turned many of us into potential Mother Hubbards; the cupboard may not yet be bare but the extra cost of filling the car that I need to use because I have no access to public transport and the rising cost of food (one everyday item up 20% from the previous week) make it extremely unlikely that I will be able to chip in more for tax.
I imagine that my fellow 9% of taxpayers feel much the same way; particularly as most of our tax proceeds are stolen by the kleptocracy or wasted on poorly planned schemes run by idiots.
But let us sip of the Kool-Aid on which Dr Crisp evidently imbibes and imagine for a moment that financing and potential fraud on an epic scale are not an issue. What else could possibly go wrong?
I may have fallen into a coma last week and if I did I offer my apologies but I either read, or dreamed, of a story about a Gauteng hospital where pregnant women were sleeping on the floor. Since several videos of the Rahima Moosa Mother and Child hospital have now appeared on YouTube I must assume that I hadn’t fallen into a coma and neither was this fake news or an April 1st prank.
It’s not as if this isn’t the only incidence of appalling hospital management in the country either. The Charlotte Maxeke Hospital in Johannesburg (formally the Joburg Gen) appears to still be a disaster zone a year after experiencing a fire. Here are a random collection of recent headlines Googled two days ago.
What did poor Charlotte Maxeke ever do to deserve this shit-show being named after her? I suspect that many hospitals in our far flung, bankrupt municipalities are not faring much better.
On the basis of how public healthcare is currently run (even in the wealthiest cities) it doesn’t fill one with enormous confidence that the introduction of NHI would do anything except compound the existing disasters and hamper any improvements with miles of bureaucratic red tape; something the ANC believes convinces the people that they are actually doing something.
We live in a country with a 28 year proven track record of the government cocking up anything it gets its thieving paws on. We can’t even run a functioning postal system for heaven’s sake so how on earth will we run a public health service? We can’t distribute driving license cards because the one machine we had was old and broken. How much confidence have you that the X-ray machines won’t be old and broken?
Then there’s the small matter of staffing. The well qualified medical people I know, trust and interact with are not too enthusiastic at the prospect of being told where they can practice, how much they can charge and when they can take leave by a communist government’s politburo. In fact, one young doctor of my acquaintance has just quit the public health system after three years out of sheer frustration at its pettiness and inefficiency.
So who does Dr Crisp think will be manning all these state of the art facilities where nobody will need to sleep on the floor prior to childbirth? Presumably the next ‘cohort’ (I love that ludicrously overused word) of medical students who will have passed their exams at the newly reduced pass mark and may occasionally amputate the wrong limb. Relax…it was on honest mistake but a valuable learning experience.
My monthly contribution to a medical aid scheme is money that could be better spent buying wine or eating out. But, responsible husband that I am, I have decided that advancing age makes me more vulnerable to the sort of ailments that afflict us oldies and would like the comfort of knowing that I can be admitted to a properly run hospital where a) I don’t have to sleep on the floor b) I don’t have to bring my own bedding and c) my family don’t have to bring me food.
It’s also reassuring to know that the medical team caring for me have passed some sort of recognizable exam and don’t all babble away in Spanish because they are Cuban imports. So there you have it Dr Crisp. The NHI is unaffordable, unworkable, unwelcome and unlikely to retain decent staff. Perhaps you should concentrate your considerable talents on repairing the current health service first. That shouldn’t take more than thirty years.
Last week Stellenbosch was treated to some wonderful street theatre thanks to the EFF with their supporters carrying beautifully printed posters which read “Whenever you see a beautiful piece of land, take it” and others which read “White people own 72% of the land in South Africa”, the majority of which is obviously farm land which is comforting news because that’s why our supermarket shelves are so full compared with some other African countries.
Sadly, none of these realities seem to have dawned on the EFF rent-a-mob who had been bussed into Stellies to take part in this piece of racist anti-white agit-prop. The thing that always amazes me is that whenever EFF crowds gather with a grievance there is much laughing, singing and dancing and the whole thing comes across more as a carnival than a protest.
I do think that if you are demonstrating against the injustices of society then you should at least pretend to look grim and serious, rather as the coal miners did back in the 1980’s when they were demonstrating against the new Thatcher government. Not much singing and dancing there as I recall.
On this occasion the great self proclaimed Commander in Chief, Julius Malema, was in attendance to deliver a set of terms and conditions to Johann Rupert who he accused of being a land thief along with the entire white population. The problem with all this nonsense is that it’s very difficult to pinpoint exactly whose land was stolen back then and who can rightfully lay claim to it today.
This dilemma doesn’t apply to the many distressed depositors with VBS Mutual Bank however. They know exactly who stole their money and have long given up any hope of seeing it again.
Isn’t it a wonderful irony that the man accusing whites of being land thieves 370 years ago is himself a money thief of a mere four years standing.