We’ve spoken a little bit about the government’s planned National Health Insurance (NHI) scheme before. Back in June, Minister of Health, Aaron Motsoaledi, revealed the National Health Insurance Bill and the Medical Schemes Amendment Bill. Though neither Bill really offered any concrete details on how everything would work, the announcement immediately had South African doctors up in arms and ready to leave the country.
That’s just the tip of the iceberg, and the problems surrounding the NHI run far, far deeper. Concerns have been raised about how the NHI will be funded, given that the costs associated with the implementation of such a system have been wildly understated. And then, of course, given that the government currently couldn’t organise itself out of a wet paper bag, the NHI will afford an uncomfortable amount of room for incompetence, mismanagement and reckless spending.
Nobody wants an inefficient state to have that much control – Exhibit: Eskom, SAA, SABC, PRASA, SA Post Office, etc.
Of course, the new legislation is designed to create greater access to medical healthcare for all South Africans, which is an amazing thing, but to do it right, it will require a massive industry shakeup on every level – from government to the private healthcare sector.
Things just aren’t going as planned, for a change.
Recently, a leaked version of the revised NHI Bill revealed that the government might be planning on banning medical aids altogether, or at the very least only permitting medical aids to cover services not being offered through the NHI – whatever those might be, nobody knows.
The people didn’t like this very much. The idea of your health, and the health of your loved ones, being entirely at the mercy of the government is a notion too terrifying to live with. This would not only prevent people from seeking private medical insurance, but highly-skilled private practitioners will be put under even further financial strain and will inevitably be forced to leave the country and seek stable work elsewhere.
Furthermore, the Department of Health also wants to regulate provincial health budgets, meaning that regional departments will no longer be able to operate their own, independent healthcare systems.
It’s an absolute debacle. As it stands, and according to a recent report released by the Office of Health Standards and Compliance (OHSC), 308 of our public healthcare facilities are non-compliant and 224 facilities are critically non-compliant with the set standards. This means that people go to public healthcare facilities to die, and this is the South African future being painted by the government as it pushes for that 2019 election vote.
Alarm bells are ringing. If the NHI succeeds in its current form, it will not only fail to alleviate the struggles of the poor, but could likely strip away any chance of decent healthcare in this country at all, for anybody.
Thankfully, the cabinet has reportedly put its foot down. Sort of.
Senior Treasury officials, the DA and several civil society organisations have fiercely opposed the NHI Bill, raising concerns about the diminished roles of medical schemes (which currently provide cover to around 9 million people) and the total lack of consultation on proposed changes to the role of provincial health departments.
Last week, the controversial NHI Bill was tabled before the cabinet, which in turn sent it back to the Department of Health for further work.
A statement issued on behalf of the cabinet on Thursday made it clear that it had not approved the Bill for submission to parliament, but did not elaborate on the precise reasons for the rejection. Neither cabinet, Department of Health or Department of Finance spokespersons would offer any comment on the situation.
The NHI Bill was not on the list of bills or policies approved for public comment, nor on the list of draft legislation given the green light to enter the parliamentary process.
According to Presidential spokesperson, Khusela Diko, the bill will likely be finalised in the New Year.
The government’s ambition of providing universal health coverage is an admirable one, and it’s something that any South African can get behind – but only if it’s done right. Unfortunately, it’s proven to be just another dysfunctional policy, rushed in every way, shape or form to meet political deadlines – and it only serves to further prove that the powers-that-be are more than willing to run roughshod over the constitution to get what they want.