In Department of Health docu-ments, the National Health Insurance is described as “a centralised, national insurance fund from which the government will buy healthcare services from healthcare providers in both public and private sectors.
“All eligible South African residents, as defined in the NHI Act, will be able to visit these providers whenever they need healthcare, without any payment.
“The NHI will make healthcare more affordable, by reducing the cost of healthcare due to the economies of scale that can be achieved by purchasing healthcare for the entire population.”
This is all commercial stuff, nothing about healthcare. No wonder arguments against it are mostly in commercial terms.
The nearest it comes to healthcare is that it is about paying for healthcare, this means that the objective is to enable citizens to pay for healthcare. In real life your health problems cannot be solved by you having the capa-city to pay for the care, you can only alleviate your condition by being attended to by a competent health professional. Without getting such help you will die with your medical aid card in your pocket.
Anyway, what “public healthcare” presently being dished out to the majority of communities is worth paying for?
Amazingly, even those considering themselves communists are puffed up about this commodification of healthcare.
My understanding of universal access to healthcare regardless of anyone’s means is that everyone can access quali-ty healthcare. This means adequate healthcare facilities within a reasonable distance of where people live, alternatively being able to be picked up by an ambulance quickly.
I do not believe this needs an “insurance”. It needs clean, well-staffed health facilities all over the country, obviously confi-gured such that several tertiary facilities with several primary care satellites that refer the more serious needs to the tertiary. And there being adequate ambulances manned by well-paid, well-motivated healthcare professionals.
There is no point in interfering with the private sector except by providing excellent service that would strongly rival the private providers to make most people forget about using them and private hospitals (private healthcare is hospitals and health professionals that are independent and not in the employ of the state, not financial services entities such as medical aids).
It is a natural outcome of the monetary system that some will generate more money than others. There is no such thing as “having money”.
It should work in the same way that you need adequate public schools while leaving the monied to take their children to private schools; or people using public transport while those who can afford cars will own their private cars.
The same principle would apply in issues of security with ordinary people relying solely on police while the rich hire private security.
A government should be concerned at the quality of service they provide citi-zens.
It appears they actually do and are embarrassed by it. But instead of mobilising funds to improve their services to citizens, they are looking at what the monied are able to afford for themselves and think that they can extend that to the rest of the population.
It is not about other countries havinf health insurance. There is no point trying to live like the Joneses. Only when the government provides facilities that rival private facilities can you speak of enabling people to pay.
- Mosalakae is a medical doctor -concerned with societal issues
