Plans to introduce NHI in South Africa will not work: analysts

The Institute for Race Relations (IRR) has criticised president Cyril Ramaphosa’s recent calls to introduce universal healthcare coverage and a National Health Insurance (NHI) system in South Africa.

Ramaphosa has said that the global Covid-19 pandemic crisis has starkly highlighted the value of universal health coverage in responding to health emergencies, and the need for robust health systems to save lives.

“Let us lay the foundation for National Health Insurance so that all people have access to the quality health care they need regardless of their ability to pay,” he said in a national address on Sunday (12 July).

However, the IRR said that the claim of  ‘quality healthcare’ for all is deceiving when the same government is responsible for failures in the existing public health system.

“To begin with, South Africa already has an extensive public health system charged with delivering quality healthcare, particularly to the vulnerable and the poor, but it is failing, and costing lives,” it said.

“Instances of grievous mismanagement, and of patients or loved ones enduring what can only be described as inhumane treatment, are commonplace. These are symptoms of chronic government failure.”

The IRR said that the government should instead focus on solutions that will guarantee quality healthcare in the public sector, rather than merely ‘importing into NHI’ everything that is wrong with the system it mismanages today.

“The NHI is not a cure-all – in fact, it is likely to be worse than the disease it is trying to cure: too many South Africans not having access to quality healthcare,” said the IRR’s deputy head of Policy Research Hermann Pretorius.

“If government-run healthcare has shown South Africans one thing, it is that government cannot successfully run healthcare.”

No evidence that the NHI will be different 

This view was echoed by analysts in an interview with The Citizen.

Unisa professor and political analyst Lesiba Teffo said that the planned healthcare insurance will likely fail, judging from how state-owned enterprises performed.

“If you want to add onto that another state-owned enterprise, one cannot say the government can do better. Some of the reasons for the collapse of the healthcare system is that it is not well managed,” he said.

A lack of engagement between provincial health departments, and private doctors, prevented a working partnership between the public and private sector, said the South African Medical Association.

The collapse is also due to inefficient structures within the system, and poor leadership in hospital management, which affected the current handling of the pandemic.

Read: Coronavirus requires universal health coverage: Ramaphosa

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Plans to introduce NHI in South Africa will not work: analysts