We support National Health Insurance, but more work required prior to implementation
15 May 2024
South Africa cannot abandon its Constitutional responsibilities to develop a just and fair State on the basis of the government’s track-record of incompetence.
Whether or not the State is presently competent to manage the proposed National Health Insurance system is not the question. The question is: Is it the right thing to do?
And, if it’s the right thing to do, how do all of us – that’s the state, medical professionals and citizens – contribute to its competent management?
The starting point, for these questions is our history. Thirty years ago, our democracy inherited a multi-tier health system: The middle-class, with medical aid, received superior treatment from private health professionals and institutions, while the State ran parallel, racialised and bantustanised health departments for the less well-off.
If we agree that all people are intrinsically equal, and equally deserving of health care, that system was patently unfair.
The democratic State has de-racialised its health offering but doesn’t have the money to offer high quality services to all who need them. The private health sector, on the other hand, is awash with money.
In Cape Town, while children die of preventable diseases every year due to the foul conditions in which they live, patients fly in from overseas for elective surgeries because – to them – our private health sector is accessible and affordable.
The level of health care citizens receive is therefore yet another measure of the gross inequality we inherited, that we have inadequately addressed post-1994, that some parties appear to regard as “normal” or “deserved”.
It is regrettable that the NHI Bill is being signed now, days before an election, because parties to the left and right of the present government will merrily distort their arguments – for and against the bill – to suit their politics of fear, mistrust and loathing.
On the one hand, they will use the Bill as a lever to scare privileged communities into believing that the NHI will deprive them of the high level of medical care they presently enjoy and pay for. On the other, they will want people to believe that the NHI is not aggressive enough in redistributing resources from privileged to poor people.
Run-ups to elections are not conducive environments for rational debate on a topic as fundamentally important as this.
Enough economists and medical professionals have raised issues with the Bill, which cannot be discounted. These concerns must be rationally engaged, and mitigated, prior to implementation. So, too, must potential barriers to the NHI’s success, including corruption, be addressed.
The GOOD Party supports the signing of the NHI Bill because it is a tool to address inequality and improve health care services for the majority of the people.
We support the Bill because we believe in the principle of universal health care, and we believe in South Africa’s future.
We urge the incoming government to develop a programme to iron out identified wrinkles in the legislation prior to implementation – with the explicit aim of developing the confidence of health professionals and the health sector.
Issued by Brett Herron, GOOD Secretary-General & Member of Parliament, 15 May 2024
