I watched a dialogue on our ailing healthcare system on eNCA and wondered how the audience, after pointing out the many serious problems and challenges that have brought our service to its knees, could conclude at the end of the debate that the only solution would be the implementation of National Health Insurance (NHI) and universal healthcare coverage.
To highlight a few of the problems that were raised in that dialogue: lack of resources such as equipment medication and other necessities, mismanagement of health facilities, under-funding of all health institutions, procurement problems and corruption, staff shortages with the eNCA showing at the bottom of the TV screen that the nurse-to-patient-ratio is currently one nurse to 218 patients, this is unheard of and a recipe for medical negligence claims. In the ICU, the correct ratio is 1:2, and in the emergency it is 1:4.
When it came to providing solutions for these problems, unanimously, it was agreed that the only solution was the implementation of NHI and universal healthcare coverage.
Do we even understand what all of this entails and its implications? NHI is a funding tool for universal healthcare coverage. It is derived from employee and company taxes. For instance, in the UK, in 1998 the conditions of employment stated that 25% of my salary would be deducted for pay as you earn and 9% for NHI, a total of 34%.
The UK currently has an unemployment rate of 3,5% and their NHS is also supported financially by the thousands of expatriates who work there, but their universal healthcare system is struggling with many problems as detailed in an article two months ago.
SA, on the other hand, has poorly resourced, poorly managed health services exploited by millions of foreigners from neighbouring countries, with a high unemployment rate standing at 33,9% currently. That means we have a very small tax base which can never provide sustainable funding for universal healthcare coverage. Implementing universal healthcare coverage under our circumstances would be disastrous.
Cometh Dube-Makholwa, Midrand
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