Why persist in failure when solutions exist?
At the end of May, previously vaccine-starved SA faces a curious paradox: the supply of inoculations against the deadly coronavirus vastly exceeds demand. At least in theory … This strange dilemma is almost entirely explicable because the government, in light of so many demonstrable serial botch-ups on this front, insists on centralising and nationalising the broken appointments system, which we were assured would be up and working, for seniors, on
May 17. I wonder how many over-60s have actually received the long-awaited SMS advising them of their place and time of appointment for the life-saving jab. I know of two such souls, one in Cape Town and one in
Johannesburg as of midweek.
Of course, from the get-go there were other solutions staring the now discredited department of health in the face. Outsource the job to the dreaded private sector, call in the hated medical aids, allow the provinces to conduct their own registration and referral system, even the “enemy” Western Cape. Or allow qualifying people to be vaccinated on a walk-in basis, which is a realistic solution that many have taken anyway.
Perhaps its paladins were too busy sourcing communications contracts for friends and family — though one current hallmark of this department is its crushing failure to communicate with its citizens.
However, there is a larger question behind this omnishambles, and it applies across our broken state: why persist on the road of failure when demonstrable alternatives are available?
It is the sort of question citizens might ask about the Post Office, for example: it cannot deliver letters or a humble package, but it wishes to ban courier and delivery companies which can. We have no money to fund our defence force and its operations but found more than R1bn to finance Cubans to repair and maintain its equipment. The police forensic labs have a backlog of 200,000 unprocessed DNA samples from crime scenes, and the same department proposes to ban firearms for selfdefence purposes.
Our public hospitals can’t provide basic equipment for patients, but the state-run Health Professions Council of SA wants to seize all the assets of the medical aid schemes to fund National Health Insurance.
On the subject of NHI, the government ploughs ahead with it despite the failures of the pilot projects, and our insolvent national purse is soon to be burdened by an additional charge of either a 31% increase in personal taxes
In the face of disasters, just close your eyes and embrace wilful blindness
or a 63% increase in corporate taxes to fund it.
Public health expert professor Alex van den Heever has written that the NHI “has no equivalent in any setting anywhere in the world … Only a failing health department could generate a proposal like this and take it seriously — let alone expect everyone else to join them in their fantasy.” And he wrote this jeremiad some months before the bad vibrations from Digital Vibes removed the shreds of credibility still attaching to the man at the centre of both the scheme and the corrupt contract, Dr Zweli Mkhize.
Malcolm Gladwell’s new book, The Bomber Mafia, provides fascinating insight into what happens to true believers when their convictions are confronted by reality or, as he phrases it, “where everything you believe in is proved false”. His conclusion: “The more you invest in a set of beliefs — the greater the sacrifice you make in the service of that conviction — the more resistant you will be to evidence that suggests that you are mistaken. You don’t give up. You double down.”
So when the private health-care providers and public health experts — who know how to run hospitals and systems — suggest the NHI is fantastical in theory and fiscally ruinous in practice, what is the response of those in charge?
According to our “reformist” and “consensus seeking” President Cyril Ramaphosa, “NHI is coming to you whether you like it or not”. And prior to sinking under a tidal wave of sleaze, Mkhize opined that NHI is “one of the best things that ever happened to SA”. Disconfirmation of their pet subject is no bar to persisting with it.
Ramaphosa has some form on the matter of doubling down on failure. The ruinous policy of cadre deployment has been on full display at the Zondo commission. It has shuttered and destroyed everything in its grasp: over 700 state-owned companies in varying stages of insolvency and dysfunction, and on the local front it is even worse. According to finance minister Tito Mboweni, 63 municipalities are in financial distress, 40 are embroiled in financial and service delivery crises and 102 have
“adopted budgets they cannot finance”.
Yet in his appearance at Zondo, Ramaphosa endorsed the policy of cadre deployment.
The five best-performing municipalities are all governed by the opposition DA, which, whatever failings are attributed to it, does not subscribe to the blunt instrument of either cadre deployment or ideological obsessiveness when it comes to service delivery.
But why change course? In the face of such disasters, just close your eyes and embrace wilful blindness.