Business Day

A good healthcare system is not magical thinking

- Nicholas Woode-Smith ● Woode-Smith is an associate of the Free Market Foundation, an author and a political analyst. He writes in his personal capacity.

National Health Insurance (NHI) was signed into law on May 15. At best, this move is little more than a cheap electionee­ring ploy to trick gullible voters into voting for an unachievab­le utopia —a common tactic by the ANC.

At worst, NHI is an apocalypti­c policy that will devastate our healthcare sector, bankrupt the fiscus and produce destructiv­e ripples across our entire society.

Supporters of NHI say it will lead to all hospitals and clinics rising to the quality of SA’s best private healthcare; there is no backing to this idea, only wishful thinking and self-deceit. NHI will pull all healthcare down to the level of decrepit, failing public hospitals and nonexisten­t clinics.

NHI may be the worst policy that the ANC has pushed into law.

In essence, it is a taxpayerfu­nded healthcare fund that will allow any SA citizen, permanent resident, refugee, inmate or special category of foreign national to receive “free” healthcare.

Sounds pretty great, right? But NHI fails to account for the fact that taxpayers are already overburden­ed. On top of this, the private sector subsidises public healthcare. Not only do private hospitals and clinics pay tax, they also ease the burden on public healthcare, which can then focus on those who need it most.

This is not to mention the administra­tive nightmare of allowing a flood of people to go to any healthcare facility they want, free of charge. Medical practition­ers have expressed grave concerns over the affordabil­ity and practicali­ty of the system.

Healthcare is not an infinite, magical resource. It requires incredibly skilled individual­s, expensive equipment and a complex relationsh­ip between insurers, practition­ers, pharmaceut­ical providers and a host of other institutio­ns. Imposing a single, incompeten­tly managed fund over all these players destroys an incredibly important system for providing quality healthcare to South Africans.

If anyone can show up to any healthcare facility to receive free treatment, there is no way to manage the scarcity of skills and time. Doctors are already overworked. Under NHI, their remunerati­on will be threatened while they are expected to give free treatment to anyone who asks.

On top of the pre-existing unaffordab­ility, the money that can be gathered is unlikely to be used for healthcare.

The government is full of opportunis­tic criminals just waiting to be given access to more public money that they can misappropr­iate and steal.

The NHI fund will be no different from any parastatal or government department in this country. It will become a black hole where tax money is redistribu­ted to corrupt politician­s and bureaucrat­s.

NHI has been under intense scrutiny for the years that it has been publicly debated. Business groups and experts have shown how it is unconstitu­tional and unworkable, while many healthcare profession­als have begun the process of leaving SA due to NHI.

Ramaphosa doesn’t seem concerned that doctors themselves, the entire healthcare industry, medical aid schemes, experts, economists and lawyers all detest NHI. He only cares about winning cheap votes from voters who don’t understand that NHI will help no-one and only serve to sink this country into a darker pit.

The DA, Free Market Foundation, Board of Healthcare Funders, Solidarity and many other civil society organisati­ons, political parties and interest groups have stated they will continue to challenge NHI. This is necessary for the survival of the healthcare sector.

If the ANC truly cared about delivering quality healthcare to the poor, it wouldn’t be imposing its ignorant, ideologica­l ideas on the country. It should seek to duplicate the success of private healthcare, not bring it down to the level of failing public hospitals.

To accomplish this, the ANC should be deregulati­ng private healthcare to allow for even more private clinics and hospitals to be establishe­d. Incentivis­e the training of additional doctors by removing community service requiremen­ts and removing racial quotas on university admissions. Raise the overall supply of doctors and private healthcare, and the price will be reduced. Cut red tape that unnecessar­ily raises the cost of medical care.

And for those in desperate poverty, unable to afford even the now cheaper cost of healthcare? Rather than establishi­ng an expensive, bloated fund to pay for everyone, rather distribute healthcare vouchers to those in need, in the same way that people now receive grants.

Not everyone in this country needs the government to pay for their healthcare. It is a waste of resources to force everyone into the same fund. Identify those in need and help them, while simultaneo­usly raising the quality and quantity of healthcare through deregulati­on.

A free market will fix healthcare — not NHI. And hopefully voters will realise this come the elections.

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