NHI will ruin SA ’ s assets

The proposed National Health Insurance (NHI) scheme represents two substantive problems for SA to the point where it is an existential threat to the country’s healthcare capability and future (“ANC MPs want to rush through NHI Bill before party conference”, November 22).

First, in terms of fiscal responsibility, funding the NHI will require a substantial (to put it mildly) increase in taxes, and therefore immeasurably more pressure on the beleaguered tax base and government fiscus. Government finances, and the country’s credit rating, are barely back on the road towards prudent management.

The second risk lies with the country’s healthcare sectors, private and public. If implemented, the NHI will centralise the management of healthcare in the country with the NHI board. The board will in turn be controlled by the person who happens to be health minister at any given time and will have the power to appoint board members.

Subjecting private and public sectors, and all healthcare personnel, facilities and materials to a single entity responsible for something as important as healthcare, stands to open up new avenues for waste and possible corruption. SA medical professionals are already looking to work in other countries. By subjecting them to yet more state management, control and inefficiency, what incentive do they have to remain?

In the global context of higher interest rates, depressed economic activity and lower growth, SA cannot afford to undertake these kinds of illconsidered fiscal and, importantly, policy risks, even more so when the proposed plan will not actually deliver improvements but rather steadily destroy the assets the country has.

Chris Hattingh Centre for Risk Analysis