The National Health Insurance (NHI) roadshows currently crossing the country amply illustrate the horror ordinary citizens suffer under poorly delivered public health services, says Michael Settas of the Free Market Foundation’s Health Policy Unit in a Daily Maverick report. Additionally, we hear public health specialists and NGOs enjoining all citizens to support NHI: “We need NHI to fix our inequitable health system” is the usual argument.
But, Settas says, this narrative is a straw man argument. South Africa does not need the NHI Fund or any other form of revised financing structure. He says, what South Africa does need immediately is to fix the management and delivery of public healthcare services – and simultaneously to implement the recommendations made by the Health Market Inquiry to reform the private sector.
Settas writes that the NHI is no more than a reshuffle of finances – and a truly bad one at that. It has nothing to do with improving the delivery of healthcare or bringing about operational efficiencies.
He says that there is a need to improve healthcare outcomes in South Africa is entirely obvious. Given the horrendous statistics I have shared above, there is tremendous urgency to do so.
But, he argues, as has become the norm in South Africa, the NHI Bill represents virtually nothing about fixing healthcare and way more about furthering patronage and keeping the state’s hands firmly gripped on the levers of power.
A report in Spotlight commentates on the recent NHI hearings held in Picketberg in the Western Cape, where MPs were shuttled in in airconditioned white mini-buses in the scorching heat. They only entered the hall at the start of proceedings. And residents had to queue at the Allan Boesak Hall in a predominantly coloured neighbourhood of Piketberg with their identity documents to be captured and have their photos taken.
The report says later inside the hall committee chair Dr Sibongiseni Dhlomo set the scene. It said what followed was a cringeworthy ‘Dhlomofication’ of one of the most important legislative developments in the country’s public health sector.
The report says, “if these public hearings on the National Health Insurance Bill are democracy in action, we are in trouble.”Full Daily Maverick report Full Spotlight report