NHI: The promise not worth the peril
25 February 2020
I have attended more than 10 public hearings on National health Insurance (NHI) over the last few months. It has become abundantly clear to me and most others who understand the policy and its context that many people still don’t grasp what it will entail and offer. Some just don’t want to see it for the catastrophe it will ineluctably be, whilst others welcome whatever outcome, good or bad, it delivers. And yet, it isn’t difficult at all to see where it will lead.
I was asked at a roundtable discussion with health minister Dr Zweli Mkhize in December whether I support the idea behind NHI. My answer was that I support improved health services for everyone in the country, but that NHI is not a means to that end. I would think all reasonable and compassionate people do.
The hearings and regular media reports have produced many heart-rending and sordid tales of people being ill-treated at hospitals, a dearth of equipment and personnel, bad staff attitudes, squalid hospitals, preventable deaths and many more ills afflicting the public sector. It is hard not to sympathise with those on the receiving end of such service (and I personally know quite a few). But to support NHI as a way of remedying these problems, is hopelessly naïve.
The bad news for those who (reflexively) support it is that it that there is no evidence to support that it will be a success and live up to government’s intention of universal healthcare. And they will not be getting all the wonderful goodies that is so loftily and vaguely promised. I have ruminated on its various guises and formats for years and still cannot find much good in it. The current dire situation of the public health sector didn’t just happen – it was caused. Ditto the mess at state-owned enterprises.