In an ardent open letter to President Cyril Ramaphosa, Michele Clarke, a member of the DA in parliament, urged for prudence to prevail over the use of “cheap political tactics” concerning the National Health Insurance (NHI) Bill.
The bill, recently approved, was initially presented to parliament in August 2019 and subsequently referred to the committee for review.
Its purpose, as stated by the National Assembly, is to achieve universal health coverage for all South Africans.
This entails granting every citizen the right to access comprehensive healthcare services at accredited health facilities, including clinics, hospitals, and private practitioners without any financial burden at the point of care.
In the letter, which underscores the concerns raised by opposition parties, healthcare stakeholders, the general public, and independent legal services, Clarke calls for a more comprehensive examination of the feasibility and potential consequences of the bill.
She highlights the widespread objections to the NHI Bill voiced by various parties, expressing apprehensions regarding the affordability of the proposed scheme.
She further argues that the failure to adequately address critical questions and the refusal to conduct a feasibility study have only deepened doubts about the viability of the NHI.
An essential concern outlined in the letter is the potential strain on health services if the NHI is implemented without proper planning.
Clarke contends that the proposed system could overburden an already stretched public healthcare system, given the nearly 9-million individuals with existing medical aid cover who would be competing for services under the ambit of universal healthcare.
“The former health ombud did not mince his words when his term recently came to an end. Professor Malekgapuru Makgoba stated that the ANC government is incapable of solving the public health crisis, likening the Gauteng department of health to Eskom, and referring to the Eastern Cape and Free State health departments as embarrassing and disorderly.
“Should the NHI come to pass, health services would collapse. To this day, the department has never made it clear which health services would be available under the NHI, and which would be out-of-pocket expenses for patients,” she said.
The letter also highlights the financial consequences for taxpayers, as the government has allegedly failed to provide clear explanations on how the NHI will be funded.
It warns that with the elimination of medical aids, individuals would lose their medical tax savings credit, leading to an estimated annual increase of at least R4 368 in taxes for 9-million people who will be affected.
Clarke raises doubts about whether the proposed NHI Bill will effectively address the causes that necessitated the presence of private healthcare in the first place.
“How can you honestly expect those 9-million South Africans to forfeit their medical aid and then proceed to fund the private health sector without any apparent benefit to them?
“One day they are receiving immediate medical attention in a private hospital, the next day they are required to travel further away to a public hospital which does not have any beds, sufficient staff, and a waiting list of seven years for certain surgeries – it is simply not reasonable.
“We can’t even be certain how the taxpayers of South Africa will be funding the NHI because your ANC comrades refuse to provide an explicit answer.
“In fact, just by taking away a person’s medical aid will mean that their medical tax savings credit [from having a medical aid] will be removed.
“The result? Every one of those almost 9-million people with medical aid would now be paying an additional R4 368 of tax every year at a minimum – and this is before any further taxes are levied for the NHI itself,” Clarke argued.
She explained further: “They also conveniently forget that South Africa already has universal health care.
“Currently, any individual in need of medical care can go to any public health facility for treatment, either for free or at a nominal fee [this would of course change under the NHI – the bill excludes asylum seekers despite the constitution expressly providing otherwise].
“Private healthcare came into being due to the failure of the ANC government to provide quality healthcare. Had the ANC done its job, medical aids and private hospitals would not be a staple in South African society.
“Mr President, I understand that the 2024 election is looming ever closer and that the ANC has nothing tangible to offer the electorate.
“There is no hiding behind fancy words or phrases, Mr President. We all know that the NHI is a last-ditch effort to fool the public into thinking the ANC actually cares, and that despite years of horrendous abuse, this time it will be different.
“The NHI will bankrupt this country beyond measure, thousands will die and any skilled medical practitioner worth their salt will leave this country for better conditions.
“Mr President, my request is simple: do not allow cheap political gain to cloud your judgement. You took an oath to protect this country.”
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