Your published SMS titled “Forget NHI, fix public health" of August 11 is spot on in characterising the proposed NHI scheme as a “new feeding trough”. The ANC’s raison d’etre is simply to stay in power to maintain access to state-owned and state-enabled resources for purposes of political patronage and crony enrichment.
But with those resources now drying up in the face of stagnant economic growth, declining tax revenue, shrinking department and SOE budgets, failing and/or bankrupt public enterprises, and a heavy and growing government debt burden, the ANC elite will increasingly try to loot and plunder what they can from any remaining wealth and resources in this country that they can get their grubby hands on.
This is the primary motivation behind the ANC’s pursuit of NHI by nationalising healthcare, pooling all healthcare resources under government control, and centralising decision-making and resource allocation powers concerning the healthcare sector.
As the SMS says, the government should instead focus on getting the basics right of healthcare so that public clinics and hospitals can be as effective as possible in fulfilling their core mandate.
Better yet, we should pursue a more innovative approach to healthcare, whereby the expenditure of funds currently mismanaged in the public healthcare sector should rather be “marketised” – converted to healthcare subsidy vouchers that are given directly to all households that need state-sponsored social protection.
Access to such government assistance would be on a staggered, means-tested basis to facilitate and ensure equitable healthcare access to the most vulnerable in society. It would also provide the dignifying benefit of putting healthcare service consumer choice directly in the hands of those beneficiaries, not of politicians or bureaucrats, thus putting them on a par with those who are privileged to afford private medical aids, and granting them the same agency and security in personal health matters.
Jabu Ntuli, Cape Town
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