Healthcare Solution Lies in a Working Public Service

Should the proposed National Health Insurance (NHI) be implemented, it will be the largest financial project ever taken on in the history of this country, the Western Cape Minister of Health, Theuns Botha, said on 4 October 2013. “The National Health Minister’s comment that NHI will not impact on tax contributions is simply not possible.”
 
Minister Botha was addressing a pharmacy conference at the Lagoon Beach conference venue in Milnerton, Cape Town. 
 
It is very important to differentiate between healthcare and health insurance, Minister Botha said. “The one is a healthcare system, the other is an insurance fund.”
 
“The DA and Western Cape Government supports the principle of a healthcare system for all, but the reality is that at present there are no calculations on the table for the NHI that National Government has in mind.
 
“It is simply not possible for an insurance fund of this magnitude not to impact on taxpayers contributions. That is the source of government money, and to say that NHI will not affect tax is a political ploy.
 
Furthermore Minister Botha said that the first world countries where health insurance systems are functional, the direct taxpayers are significantly higher than the global average where more than 80% of the people are direct taxpayers. “NHI is definitely a healthcare system that we would like, but in the country’s current state, it simply is not affordable. That is why the DA favours the strengthening of the existing healthcare system, rather than inventing a new system.”
 
Thirdly, the NHI in its current format is set to destroy the private healthcare sector. “To be an economy driver, healthcare should be demand and supply-driven,” said Minister Botha. “Healthcare should run on the sound economic principle of the best performers making the profits. In the Western Cape in the past four years, we have demonstrated that the private sector is willing and eager to work with our government. In health we have brought private sector partners on board, and they are financing infrastructure, equipment and services that simply is not available in our government budgets.”
 
However, Minister Botha pointed out that the most serious concern is that the proposed NHI will be a fund centralised in the National Health Minister’s office. Provincial Departments will disintegrate and become agencies of the National Health Department. We believe that the model of decentralisation is the model that creates opportunities for excellence and economic growth. 
 
“The solution does not lie in inventing a new system. The solution is in appointing fit for purpose health managers, strict and controlled financial management, and political accountability.
 
“The collapse of the health system in the Eastern Cape demonstrates a lack of management, no financial control and no accountability.  
 
“The problem is not a lack of money. South Africa’s per capita health expenditure is 50% higher than the global average. It is within our means to have an universal healthcare system if we get management, financial control and political accountability right. That is why the Western Cape health system is performing so much better than in other provinces.”
 
In closing Minister Botha said that NHI is not the solution to our apartheid legacy. “Universal healthcare is the solution.”