Health Minister Aaron Motsoaledi says private sector players are inflating the estimated cost of the NHI in attempts to “scare people off” the plan.
He has already accused Momentum Health Insurance of “mathematical hooliganism” after its claim that it could cost R1.3trn to run the NHI, saying this figure was deliberately intended to frustrate people, reports News24.
“This sum of R1.3trn a year is as much as the entire government budget for this year,” he said.
“The publication of this number is disingenuous and deliberately circulated to anger the public because it will sound crazy for the state to introduce a health financing system that will cost the same as or even more than the total budget of the country.
“The calculation of R1.3trn was reached by simply multiplying the average cost of private healthcare by a population of 61m people.”
Motsoaledi added that “this manner of calculation makes a spurious assumption that under the NHI, all South Africans will only utilise private hospitals”.
“The NHI has never proposed that we will abandon thousands of public clinics, health centres, ordinary hospitals, academic hospitals and general practitioners in favour of all South Africans attending private hospitals only.
“The NHI is designed to reduce the over-utilisation of hospital care and to reduce costs of healthcare.
“What it proposes is that all health facilities, public and private, have to be accessible to all South Africans if and when their healthcare needs demand it, but this will be done in an affordable manner.”
Motsoaledi, in another News24 report, also said it would be futile to have a meeting with Business Unity South Africa (Busa) about the NHI without the involvement of President Cyril Ramaphosa in the proceedings, and denies dodging a meeting with the organisation.
He also told delegates at last week’s Business and Civil Society National Summit on the NHI Act (in Cape Town) that he saw no reason to improve or build new health infrastructure before NHI implementation.
“I am waiting for the President to have a meeting with Busa. There’s no point in me going to that meeting … to say what? Because most of the time they are complaining about me anyway,” Motsoaledi said.
“Let the President come and chair the meeting and hear where the problems are. That’s what we call facilitation. As you know, he is a very good facilitator. I am still waiting for that.”
But Busa CEO Cas Coovadia criticised what he called Motsoaledi’s “inappropriate rhetoric” at those who have raised legitimate concerns about the NHI Act.
Coovadia argued that raising concerns was not only appropriate, but a responsible and necessary course of action.
Busa maintains it has a “genuine commitment to healthcare reform” because it is a social necessity and is essential to driving desperately needed economic growth.
“We are disappointed that despite commitments by the government to engage on the NHI, structured discussions have not yet taken place. It is only through formal, constructive engagement with the President, Minister of Health and National Treasury, focused on collaboration rather than division, that we will create a healthcare system that is equitable, effective and sustainable for generations to come.”
Motsoaledi said he had asked the President to “bring all of the parties dissatisfied with the NHI, especially BUSA”, together for an engagement. He also dismissed the arguments of those calling for NHI to be put on hold – to maintain or rebuild hospitals and clinics, buy equipment and retrain doctors. “It puzzles me… Why should it be a precondition for implementing NHI?”
He referred to the creation of a single education curriculum in 1994, eliminating the white, Indian, coloured and Bantu systems that existed before. “Four times (more) was spent on a white child than a black child. The result was a lack of resources in Bantu education schools. There were no classrooms, there were kids under trees. We had no libraries, no sports facilities and grossly undertrained teachers. But come 1994, what did we do? Did anybody say we can’t have one education system because in Bantu education they are still so far behind? No.
“The day Nelson Mandela became president, we declared one education system for all – same curriculum, same exams, same certification process. Imagine if we had … said we must build first … Bantu education would still exist.”
Meaanwhile, Sanlam CEO Paul Hanratty says it will take at least half a century to achieve universal healthcare in South Africa, which is why Sanlam “will continue to invest in developing new health insurance products for its healthcare business AfroCentric”.
“What NHI should mean is that we find ways between the private and public sector of gradually taking better healthcare to the whole population,” Hanratty told News24.
“People don’t like it being said, but realistically, that’s a 50-year journey for a country like South Africa. To have West Coast US-style healthcare for a population of 60m, that’s a 50-year journey for us.”
The group had boosted its stake in AfroCentric from 28% to almost 60% last year, he said, shortly after Sanlam reported a 43% jump in interim headline earnings to R9.8bn for its year to end-June.
Hanratty’s comments echo warnings from other business leaders.
“I keep saying to people that for me, NHI still remains a concept. It’s very hard to say what its impact is until you know exactly what it is,” he added.
“If it wipes out private health insurance, well, then obviously that’s not going to be very good for a big chunk of our business. But I actually just don’t see that as a likely future.”
Despite AfroCentric underperforming and Sanlam’s interim results warning that the NHI continues to be a long-term uncertainty for the unit, Hanratty said the group would continue investing in the business, which has operations spanning health insurance, underwriting services, medical scheme administration and pharmaceutical supplies.
News24 article – Organised business slams NHI emphasis in health compact (Restricted access)
News24 – Universal healthcare in SA a 50-year task, warns Sanlam as it pushes innovation
News24 – 'They complain about me anyway': Motsoaledi denies dodging BUSA, calls for facilitated meeting on NHI
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Organised business slams NHI emphasis in health compact
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Motsoaledi to increase push for NHI