Conscience of a Centrist: Life, health should be beyond profit

Johannesburg – A friend died this week.

His fate was sealed by his medical aid, which declined to authorise a critical operation he ought to have had to give him a fighting chance.

This served as a cold reminder that life and death can be determined administratively, that medical aids can decide who lives and who dies.


Twenty-first century capitalism seems to be driving us further away from the goal of universal health coverage, shifting obligations from the public provision of basic services to private households and individuals to borrow money to “invest” in their health and wellbeing.

There is a hidden consequence of this system: an unfolding crisis in healthcare driven by the greed of corporations whose profit-seeking model is also failing.

The commodification of healthcare was always a bad idea, but the tolerance of the system well into the 21st century is stupidity.

The dogmatic embrace of markets has increased inequality and limited who benefits from economic growth and who gets access to top healthcare that only money can buy.

Over the last few decades, South Africa has witnessed skyrocketing healthcare costs, far outstripping inflation.

Data from Statistics South Africa released last year show that more than 47-million South Africans did not have medical aids, with just 9.4-million people enjoying the benefit. However, being on a medical aid does not guarantee one that the capitalist system will treat one with kindness and consideration when one’s health hits rock bottom.

The mooted National Health Insurance (NHI) must be a reality in our lifetime to ensure no one’s life can be reduced to administrative action in the pursuit of maximising profits.

The objective of the NHI is to ensure that in a country as unequal as SA, all citizens are afforded the right to quality healthcare.

The notion is a noble one, and one that we should all support, knowing that a healthy nation is a productive nation.

Those on the right side of the debate would have us believe that universal health coverage is better viewed as neither owed to us by the government nor a government give-away; both labels are mischievous.

A more insightful analogy is universal public education. Universal public education, for all its present shortcomings, is in fact a proven extraordinary public investment. An educated population provides both a more effective citizenry and a more productive workforce. In the same way, universal health coverage is a smart public investment.

Done right, it will return far more to our national prosperity than it costs taxpayers. In a globalised world where competition is high, you don’t only need an educated workforce but a healthy one as well.

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