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Published on May 20, 2016
DR CHRIS ARCHER
South Africa’s proposed National Health Insurance contains many ambitious goals, including the idea of “free healthcare for all”. The South African Private Practitioners Forum supports the notion of Universal Health Coverage and agrees that all South African’s should have some form of health insurance
However, we question government’s attempting to provide “free healthcare for all”. The question government should be addressing is: What is the best way for the poor to gain access to quality healthcare?
The problem with the proposed NHI scheme is that it is thick on ideology and thin on practical details. Our Practitioners Forum’s view is that the most affordable way for government to improve access for the poor is to use scarce taxpayer resources to pay medical scheme premiums for the poor rather than try to insure the entire nation.
Government should use the same constitutional framework as it does for other constitutionally mandated objectives, such as housing and education. This is where the state cares for the indigent and leaves the voluntary private market alone. Deregulating the private sector would unleash the forces of competition and minimise the states responsibility for health care.
As the White Paper suggests the proposed funding source are “uncertain” and each of the proposed funding ideas will be difficult or impossible to implement. Government should establish the best way to use the funds that it already has at its disposal and not impose further taxes on the already overtaxed population
The proposed mandatory payments into the central NHI Fund will crowd out private insurance as cash strapped individuals will not be able to afford to pay their voluntary private insurance premiums as well as the mandatory payments. People who are unable to pay the two premiums will be forced to use the already over-stretched public health service.
The difficulties experienced by developed nations that have attempted to provide free healthcare for all through a single payer model should be a warning to South Africa. In Canada waiting times for medically necessary procedures have increased from an average of 9.3 weeks in 1993 to 18.2 weeks in 2014.
Procedures such as hip, knee, and back surgery have waiting times that are now a staggering 42.2 weeks and for neurosurgery the average waiting time is 31.2 weeks
The NHI proposals seem to be more concerned with removing the so-called “two tier system” than trying to design an affordable mechanism to provide quality healthcare for the poor
The state does not have to provide “free healthcare for all”. It should focus its resources on those that need and cannot afford to pay for healthcare. The rest of the population should be left to decide for themselves how to spend their money.
The famous US satirist PJ O’Rourke summed up the consequences very well when he said, “If you think healthcare is expensive now, wait until you see what it costs when its ‘free’”. yt:cc=on