The NHI cannot succeed

SOUTH Africa's National Health Insurance will tackle the unacceptably high levels of inequality related to health-care services. Simphiwe Mbokazi African News Agency (ANA)

Yet another positive article about the future of the NHI appears in your newspaper, this time by Ms Phumla Williams and, yet again, the writer is out of touch with reality.

Let writers stop living in Disneyland and come down to earth and face reality. Let us first look at how South Africa manages the current health care system. Bad news. It’s a complete cock up. Since Mandela ended his walk to freedom and the ANC took power, the state of our health system has gone down the drain. Yes, like all systems, there are little pockets of excellence, but generally the hospitals are failing on a daily basis, medicine is stolen, then sold to patients at higher prices, many patients spend most of their stay in the corridor, rather than the ward. It’s fairly normal for sick people to sleep on the floor and it’s not unusual for patients to die while waiting months for treatment. Can this be true? Just read The Star.

Many, many South Africans make the silly mistake of thinking that, because the more wealthy pay thousands per month to belong to medical aid companies and because they get treatment at far superior hospitals (where they are not asked to bring their own bedsheets!) many believe that this is unfair to the poor and the government should  take from the more wealthy people and their hospitals and give some to the poor. This is really, really stupid because all you then do is weaken the successful system and cause more business people to move overseas.

The same mentality is often used by people who think that the private and independent schools (paid for by parents at fees many times higher that those paid by less-well-off parents) are to blame for the terrible standard of education offered to the majority who are, generally black. So, the less intelligent of our members of parliament, in particular, want to force the successful schools to enrol more of the poor population who, generally don’t pay their school fees. It sounds pretty stupid when you say it like that. That’s because it is pretty stupid. You don’t improve the poor schools by damaging the private schools! What you do is concentrate on improving government schools and attempt, where possible, to learn from the private and independent schools.

The same applies to the health sector. Walk through the average government hospital and then compare it with the well-run, clean, efficient private hospitals. Then ask yourself how can I improve the government hospitals and health service to benefit the poor of South Africa? Why do the private hospitals work and why do the government hospitals fail? Why is the paint peeling off the walls of the government hospital? Why are the sewers backed up? Why is it the staff in many government hospitals don’t care if you die while you wait? Why does the government doctor ask for a donation in order to  serve you sooner? (Yes, it happened to me).

What do the private and independent schools succeed where, generally, the government schools fail? Why is the  Matric pass rates so high in private schools and so low in most government schools? Why do we set the standard so low in government schools resulting in the Matric certificate having little or no value in the workplace?

Wake up South Africans and face reality. You cannot wave a magic wand and make the NHI system perfect by building it on a foundation that is failing, that is corrupt. You can’t make the NHI service work without, wait for it, deducting money from the salary of every working black person, down to the maids and the gardeners! Did you hear me? Everyone will have to contribute money, every month, for the whole of their working life in order to pay for the NHI. How do I know? Because every NHI system in the world makes everybody pay towards the NHI system. You, the average to low earner may say, but why should I pay? Well, think about it: The current South Africa health system does NOT work. It’s a sad joke. Don’t lie to yourself by pretending it works. It does not. 

Ms Williams says, in her wisdom: ‘Through the NHI, the government envisages that private and public health care can equally share resources to accommodate all South Africans who need medical care without compromising quality and service standards’. Wrong! This is another way of saying, let the poor patients go to the private hospital and pay nothing to punish the private health care system from being successful. That’s just plain stupid. Think about it (please!); How many private hospital groups and medical aid schemes would leave South Africa if they are forced to share their money and fascilities with the poor people (however deserving)? 

All that would happen is that the standard in the private medical system would drop while the government health system would remain exactly where is is today. In addition, once a fund is created from the monthly fees deducted from the population, you and I know that many of the people in charge of spending those funds would steal much of the money. Why do I say that? Read The Star! Watch the news!Ms Williams hints that the new healthcare system will “reverse the inequalities in health care inherited from the apartheid system.” Rubbish. The ANC have had about a quarter of a century to improve health care and have totally failed.

You don’t improve a failing healthcare systems by punishing a successful one. You don’t improve government schools by taking away from the success of private and independent schools. Wake up South Africa before you fail, as many other African countries have failed. South Africa can lead Africa. South Africa can show the rest of the world that is can be a great success story. All it takes is common sense and NOT lying to the people. 

Richard Stewart is the Production Manager of the Fleet Street publication ‘The Law Society Gazette’. He came to Africa in 1975 and have spent most of my life marketing health and educational films on behalf of companies such as Encyclopaedia Britannica, BBC and National Geographic. He made many bulk film sales to SABC and other TV stations across Africa and around the world.