NHI White Paper proposals are simply unaffordable
13 December 2015
The Democratic Alliance (DA) reaffirms the South African nation’s constitutional and ethical obligation to provide all of our citizens and legal residents with “access to health care services, including reproductive health care" and for the state to ‘take reasonable legislative and other measures, within its available resources, to achieve the progressive realisation of these rights.” (Bill of Rights, Section 27).
Our initial analysis of the proposals contained in the national government’s National Health Insurance (NHI) scheme, as outlined in the recently released White Paper on National Health Insurance for South Africa, most if not all of which are not new and have been circulating about for two decades now, present some intractable problems that must be solved for the initiative to have any credibility:
The NHI will require a monumental amount of money to run and will be the second largest, after nuclear energy, fiscal risk the nation faces. According to the White Paper an additional R71.9 billion taken at 2010 prices will be required by 2025/2026. To fund it will require additional taxes under circumstances where citizens are groaning under the strain of low growth, unstoppable large-scale plundering of state resources and assets, a growing and unsustainable debt to GDP ratio and spineless fiscal management we expect in the aftermath of Minister Nhlanhla Nene’s sacking, as we hover perilously above junk status ratings.
Centralises decision-making power in structures and individuals who are remote from the day-to-day practical delivery of health services. A highly centralised version of the United Kingdom’s National Health Service (NHS), but without the infrastructure, human resource depth to match, the NHI will be an entity that will both collect and distribute vast sums of money, creating opportunities for corruption and poor governance as is repeatedly demonstrated inability to run state-owned enterprises such as SAA shows.