NHI will cover everything, says Motsoaledi

THERE will be proverbial blood on the floor when the national health insurance is implemented, warned Health Minister Dr Aaron Motsoaledi yesterday.

He said it would be shed in the private sector and that was the mess which had to be dealt with.

He counted procurement and supply chain management among the biggest problems in the public health sector, which left workers without the basic tools of the trade.

“The poorest get the least in services while the rich get the most,” he said at the Sefako Makgato University in Pretoria last night.

Motsoaledi said both private and public health had problems.

“These will have to change with the introduction of the universal health coverage tool,” he said of the pending introduction of NHI.

There would be resistance because people had become used to doing things their own way, he said.

He told his audience an analysis of the private health system had found it was extremely expensive.

He gave examples of the costs, which he said were exorbitant and quickly depleted funds.

“Once they (patients) run out of funds, treatment is immediately stopped and they are kicked out,” Motsoaledi said.

He said healthcare workers in the private health sector no longer practised the basics of handling a new patient.

“They no longer check the pulse, but check your pocket,” he said.

They looked for a medical aid card and when they didn't find it, looked for a credit card.

“If that is not there, they look for cash and if there’s no money they turn you away,” the minister said.

This, he said, had changed the face of health care delivery.

Motsoaledi said universal health care coverage would remove the barriers to health care, which included finances, and would reduce the large health expenses and ultimately contribute to better quality of life.

“It will alleviate poverty and improve human development,” he said.

The country also needed the NHI to deal with the four burdens of disease, which included communicable diseases and trauma from vehicle accidents.

Violence between people and on the road was the fourth burden on the health system, and it stemmed from the violent nature of South Africans.

Motsoaledi said it was embarrassing when doctors from overseas were sent to SA to learn about treating stab wounds, “when we are not even at war” .

He blamed private hospitals for pushing costs up in their quest to make it on the stock exchange.

“That is where the money is going,” he said, adding that a hospital on the stock exchange would deal with patients as a business dealt with clients.

He said the NHI would be funded through mandatory prepayment for health care.

The predominant payment for medical care was cash and this was a big problem.

“Medical aids do that, but only for the 16 percent privileged few,” he said.

Too many were left out of the private health care sector: “When 80 percent are left to rely on one public sector this led to a collapse of the system.

“The introduction of NHI will cover everything.”

He said it would usher in a change in the system in both private and public sectors.

Aaron Motsoaledi.