‘Can we trust government with bigger budget?’

With the ink drying after President Cyril Ramaphosa signed the National Health Insurance (NHI) Bill into law this week, one question remains: now what?

Organisation Undoing Tax Abuse (Outa) accountability division executive director Stefanie Fick said Outa fully supported the constitutional right of all South Africans to proper health care, but warned the government was creating false hope by signing the NHI Bill into law so close to the national elections.

“There is a big disconnect between the dream of the sort of universal health care envisioned in the NHI Bill and the reality of implementing it,” she said.

“Our country is in crisis on so many levels. For a universal health care system to work, you need enough funding and proper management, something that is sorely lacking at this stage of the country’s history.”

Fick said South Africans should not forget the corruption with money meant for equalising health care during the Covid pandemic. “We haven’t forgotten the Digital Vibes scandal or PPE [personal protective equipment] corruption,” she said.

“In Gauteng, we are also still waiting to see justice for Babita Deokaran, who was murdered after exposing massive corruption within the Gauteng health department and, specifically, at Tembisa Hospital.

“Can we trust the government when a much bigger health care budget comes into play?”

Dr Ivan Jardine, an ear, nose and throat surgeon in Bedfordview, said universal access to health care was everyone’s dream. But he had reservations.

“In reality, it won’t work. I love treating my patients, and I never want to deny anybody health care, but it’s not practical,” he said.

“Good health care starts with water, electricity, good food and exercise. Health care doesn’t start with medical aid and in hospitals.”

He questioned how the government would provide NHI if they couldn’t even provide electricity or water.

“As far as I am concerned, they are eyeing the honeypot of money sitting in medical aids,” he said.

“Private health care is not perfect, but at least it works. It is expensive, but it works.

“The reality is, we don’t have enough taxpayers – only about 10% of people pay taxes – and those are already carrying some on their backs with social grants. How much more can they tax us?”

Jardine said those milking the health care system with tenders and overpricing were why state health care was failing.

“Every R1 they overcharge in government hospital tenders is R1 stolen from poor people,” he said.

NMG Healthcare executive head Gary Feldman said they supported the goal of expanding universal health care.

The private health care system would carry on operating until the NHI was fully implemented, “which could take many years”.

Health Funders Association chair Craig Comrie said they were concerned about the long-term implications of certain sections of the NHI Act and its ramifications for the quality of health care, the sustainability of the health care system and, by extension, the rights of patients to quality care.

Comrie said the NHI Act in its current form would not achieve equity in health care.