NHI will be ‘gutted by graft’
SAME TRAP, NEW NAME: NEW ENTITY WILL BE PREYED ON AS OTHER SOES WERE, SAYS EXPERT
Public health policy guru says the NHI is not going to solve the problems in healthcare.
Concerns have been raised that the government’s plan to set up a National Health Insurance (NHI) scheme will result in another state-run monopoly that will be susceptible to corruption and mismanagement.
These fears were voiced by Alex van den Heever, an adjunct professor at the University of the Witwatersrand (Wits) School of Governance, who was one of the speakers at a panel discussion on the NHI at the SA Vision 2030 Summit in Ekurhuleni last week.
Van den Heever, who is chair of Social Security Systems Administration and Management Studies at the Wits school of governance, is a vocal critic of the NHI and has more than 25 years of experience in public healthcare policy and advocacy.
“Tenders and the existing framework in government healthcare have also been affected by a system of patronage, which is endemic in the current system,” he said. “A new government monopoly – in the form of the NHI – is not going to solve the problems in healthcare.
“Besides the huge costs associated with the NHI, I believe the plan will create another state-run monopoly that is destined to fail and become racked by corruption and state-capture issues the likes of Eskom, Transnet and other state-owned enterprises (SOEs) have faced in recent years,” he added.
He noted the NHI plan included mass purchase of healthcare drugs. “With the NHI, we will create a ‘monopoly purchaser’, which could open the system to grander scale corruption, like at Eskom.”
He said that while the SA healthcare system needed reform, improvements could be achieved “incrementally over time” with more accountability and policy regulation, rather than through “one big monopolistic state-run national plan”.
“There needs to be reform in the health department at national and provincial level as well as within the private healthcare sector, but we can’t have one big plan and wait for the NHI to sort things out.”
Responding to Van den Heever’s criticisms, Dr Nicholas Crisp, an advisor on the NHI to the department of health, said a major overhaul of the whole healthcare system was needed. “Some 45 million South Africans are not getting adequate healthcare and we are seeing more unhappiness around the country. We hope to help turn the tide with the NHI,” he noted.
Neither Crisp nor Van den Heever went into the exact costs associated with the NHI plan, but various reports have put the bill at between R70 and R256 billion.