NHI might be a pot of free cash

One thousand years: that’s how long it’ll take for South Africa’s National Health Insurance (NHI) to kick off according to a Wits University professor.

That’s how long I anticipate the queue for appointments to be too.

Yes, NHI is a beautiful idea, a Utopian ideal right up there with socialism and universal love. But the route word of Utopia – a fictional island – is in the Greek for “no place”. Utopia doesn’t exist.

Given that the real world is beset with graft, nepotism, greed and corruption – as whistle-blower Babita Deokaran would attest to, if she hadn’t been murdered – NHI might as well be a pot of free money left outside a casino.

And while we dreamers dream our Utopian dreams, the sticky-fingered are getting wetlipped in anticipation.

After all, how many pairs of children’s skinny jeans would an entire NHI system require, how many R10 000 buckets, how many tons of R500/kg boerewors?

The Republic of Ireland has a public health service called the HSE, a bit like the UK’s NHS.

Here’s how it works: when I went to a public hospital emergency room, I paid €100 (about R2 000) at the door (I’m guessing the unconscious pay later).

I was triaged, and then I waited. And waited.

Finally, 14 hours later, I went home with a clean bill of health, and a few months afterwards I was recalled for a heart scan just in case. This was free on the state/ taxpayer.

Mine was an emergency that turned out not to be. The system worked.

The system also offers free cervical smears, vaccinations and so forth for all, regardless of income.

However, I also have private health insurance.

When I seek non-emergency medical treatment, I might end up in the same place as “public” non-paying patients with the same doctors, but my insurance pays, or I do.

As a “private” patient, I’m in a shorter queue for care. I skip public health waiting lists – not quite 1 000 years, but maybe two or three – and the doctor gets to charge private rates and play golf and pay their mortgage and, most importantly, stays in the system, providing a public health service propped up by a private one.

It’s not Utopia, it’s not fair, but it’s not broken.

And it’s never yet needed even one pair of skinny jeans.