Your editorial opinion ("Godongwana’s call for NHI settlement marks a welcome shift in government’s tone“, January 22) refers. The best outcome from South Africa’s long-running National Health Insurance (NHI) saga would be to bury the idea.
From initial floating of the idea to nationalise the management of all healthcare in the hands of the state, through numerous public participation processes, submissions, healthcare professionals’ feedback and concerns voiced, and now court cases, the common thread has been that the state is unwilling to do the difficult work of fixing the public healthcare sector.
Pooling the resources of the private sector with the public sector will not fix the structural policy and political problems that plague the public sector. State advocates of the NHI have not accounted for the fiscal and human capital implications. The uncertainty generated alone has caused some healthcare professionals to seek work outside South Africa.
Over the last 18 months the South African economy appears to have turned a corner. Healthcare is a critical part of the economy. If court cases are the route to ensure the NHI is not implemented they must continue — even if that means the two “sides” remain at odds.
The government needs to find the political will to break the policies that incentivise waste and corruption in the public sector and constrain investment, healthcare training and low-cost benefit options in the private sector. Anything else is a distraction from the necessary work.
Chris Hattingh
Centre for Risk Analysis
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