The deadline for submissions on the draft National Health Insurance (NHI) Green Paper is history. South Africa's healthcare policy is at a critical crossroad as we await government's response to the views expressed by the people.
Given the lengthy and detailed discussions that have taken place over the years, the Green Paper left me appalled at the lack of detail and the number of unsubstantiated claims it contained. The Green Paper insinuates that the private sector is to blame for the country's failure to address core health care deficiencies. It largely ignores the failures of the country's own public health system and suggests that its poor performance can be addressed simply by passing legislation!
And it totally ignores the reams of evidence obtained from other countries with socialised health systems that these systems are inefficient, expensive, lack sophisticated medical equipment, have long waiting lists for medical procedures and appointments with specialists, do not provide equal access to and equal treatment for all citizens, provide lower quality health care than private systems, control costs by rationing care and medical technology, and fall far short of attaining their lofty ideals.
According to the Green Paper, government is disturbed by the rapid growth of the "uncontrolled commercialisation" of private health care. But, private health care is already heavily regulated. To imply that it is "uncontrolled" suggests that government imposed laws and regulations are ineffectual. Substantial market movements have taken place in response to government regulations, which display compliance with regulations. Contrary to the views expressed within the Green Paper, the existence of the private health care sector greatly benefits the people of South Africa, including the poorest members of the population.
What the Green Paper does not address, is the root cause of the poor performance of the overall South African health care sector, which, according to international surveys, are the inefficiencies and inadequacies of the public health sector. The Health Department has misdiagnosed the problem. The proposed NHI cannot and will never address South Africa's health care deficiencies.
The Green Paper states, "The South African health system is inequitable, with the privileged few having disproportionate access to health services. There is recognition that this system is neither rational nor fair".