NHI will leave everyone in South Africa worse off: CEO
Business Leadership South Africa (BLSA) chief executive Busi Mavuso has warned that the government’s National Health Insurance (NHI) plans – in their current form – will spell the end for private provision of healthcare and will leave everyone in the country worse off.
While the NHI bill – recently rubber-stamped through parliament’s portfolio committee on health – purports to bring universal healthcare to all at an affordable price, Mavuso said that the ultimate result is more likely to be a bureaucratic mess that takes all choice away from patients, while killing private healthcare providers.
“In my view, the NHI envisaged in the bill would leave all South Africans worse off in a system in which state provision becomes impossible and private health provision is effectively closed down,” she said.
“The system would impose a single-payer model in which government is the only buyer of healthcare services for its citizens. It would relegate the private health insurance market to only complementary healthcare that is not covered by the state scheme.”
According to Mavuso, not only will the scheme effectively shut down the private sector and remove a host of choices and competition from the market, but the NHI format proposed would also be hugely expensive for the country.
It will draw resources out of the rest of the government and the services it provides while increasing the tax burden on all citizens, she said.
“But most importantly, we have no reason to believe the quality of care it provides would be an improvement on the status quo. By forcing the private sector out of the provision of all but a limited set of complementary services, private provision would effectively cease,” she said.
This will have significant knock-on effects on South Africa’s attractiveness for globally mobile businesspeople and their families and would be another serious disincentive to work in South Africa, she said.
“To be clear, business would benefit from an environment in which everyone had good quality healthcare – but one in which no one had it would be catastrophic.”
Instead of learning from the energy crisis and working together with the private sector, the NHI scheme appears to lean into the worst of the government’s tendency toward populism and nationalisation.
Mavuso said that other countries have effectively delivered universal healthcare in partnership with private healthcare providers, including developing nations like Thailand and Brazil.
Critics
The BLSA CEO is far from the only commentator lashing out at the NHI and what it wants to do to South Africa’s healthcare sector.
However, groups more directly tied to the sector have also, in the past week, come out with strongly-worded opposition to the coming laws.
The Health Funders Association (HFA), which represents most medical schemes in the country, said last week that it rejected the NHI bill in its current form – echoing sentiments from the South African Medical Association (SAMA) days earlier.
Both groups, which have a firm standing in the private healthcare sector, have pushed back against many aspects of the laws, including the limitation on medical schemes, the lack of clarity on financing, the potential flight of skills and a drop in quality healthcare.
This echoes many criticisms levelled against the bill, which have argued that provisions are vague – particularly around funding – and that not enough modelling and testing has been done to see if the country is even equipped to implement it.
Notwithstanding provisions in the bill which have already been declared unconstitutional, warnings from parliament’s own legal teams have already stated that parts of the bill will open up the government to legal challenges on constitutional grounds.
SAMA added that trust in the government’s capability to manage the over R500 billion budget efficiently is severely eroded – especially given how Covid-19 funds were mismanagement, among various other corruption scandals.
Read: Medical schemes warn of tax hikes, emigration and corruption as government pushes through NHI
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