Take Ramaphosa’s NHI promises with a pinch of salt and a few pills

23 April 2024

Pres. Cyril Ramaphosa’s statement that the National Health Insurance (NHI) will put an end to the “apartheid that prevails in the health care sector” is a deliberate disregard of certain key facts about the system, said Theuns du Buisson, economic researcher at the Solidarity Research Institute (SRI).]

Solidarity is skeptical about the latest promises made by Pres. Ramaphosa regarding the NHI because the reality of the healthcare system in South Africa is vastly different from the picture painted by Ramaphosa in this regard.

According to Du Buisson, it is important to acknowledge the origins of the existing infrastructure of large hospitals in South Africa, which mainly had been built before the ANC came to power. “Since the ANC came to power, almost no attention has been paid to the maintenance of state hospitals. Only private hospitals have been built by the private sector,” Du Buisson said.

The success of private hospitals proves that the private sector can function efficiently and independently. Furthermore, it is a clear indication that the NHS cannot work and that functioning health services are dependent on private management. “The ANC government is the cause of the system functioning the way it does. This government has let the public health sector fall into disrepair. They have introduced policies that increase unemployment. They have introduced policies that prevent medical aid schemes from offering affordable options. To expect that they will be able to roll out the NHI in a good way is insane.”

Furthermore, Du Buisson says that the accusation of apartheid in the current healthcare system no longer applies as the majority of medical aid membership in South Africa is taken up by black people. This membership actually reflects the demographics of the labour market as a result of free choice and not as a result of any conspiracy, as Ramaphosa implies.

“It is clear that the ANC government is the primary reason for the current state of the healthcare system,” Du Buisson said.

According to Du Buisson, the ANC did not only allow the deterioration of the public sector; it also implemented policies that promote unemployment in the public service and prevent medical aid schemes from offering affordable options. “Therefore, to have expectations that this government will be able to successfully roll out the NHI is totally unrealistic,” Du Buisson said.

Even if the ANC could establish a workable healthcare system under the NHI, it is unlikely to be successful, as doctors do not want to work for the state.

Du Buisson also mentioned that South Africa does not have the necessary financial resources to support such a system, which will lead to a further reduction of quality healthcare services while the costs are borne by those that already are most vulnerable in the country.

Issued by Theuns du Buisson, Economic Researcher: Solidarity Research Institute, 23 April 2024