The South African Federation of Trade Unions (SAFTU) has come in support of the government’s proposed National Health Insurance (NHI) scheme, saying part of the reason was that the new system would end ‘racialised’ healthcare (‘NHI only way to end present racialised health regime – SAFTU’, Politicsweb, 28 August). SAFTU claimed that one of the problems with the current two-tier system is that it is ‘racist’.
Ideologically, it is no surprise that SAFTU and its spokesperson, Patrick Craven, have an issue with a private system of healthcare, but it is incorrect to call it a ‘racialised’ system, an indication of how the left in South Africa views issues through a racial, rather than class lens.
According to the latest data from Statistics South Africa, nearly half of all people covered by medical aid are black. Overall, whites account for only about a third of all people covered by medical aid schemes. Coloured people account for about 10%, and Indian South Africans seven percent. One can criticise the current system, but to call it a racialised system, is simply incorrect. One must ask why Mr Craven wants to deprive black people of choice in how they receive their medical care?
Mr Craven lists a number of problems in the public healthcare system – from the Life Esidimeni catastrophe and the shortages of nurses in various hospitals to the fact that only 15% of public hospitals meet the current norms and standards for participation in NHI – but seems to think that more government control will somehow solve these problems. The fact is that it won’t.
Forcing more people into the public sector (which NHI will do, as the private sector will eventually cease to exist under the state system) will only cause more problems. The truth is, NHI will not reduce the burden on the public sector, but only increase it.
The NHI is going to be a huge government bureaucracy – perhaps the biggest in South Africa’s history. And it is clear that the government is bad at running most things – the disasters at Eskom, South African Airways, and a number of other state-owned enterprises (SOEs) is evidence of this. In addition, even well-resourced countries – with more capable governments than ours – which have a single-payer system, such as Canada and United Kingdom, struggle to provide timeous and quality healthcare for all. There is no reason to think that South Africa will be able to.