NHI: Very Dangerous if Ever Fully Implemented

By Dr Eugene Brink

In June last year the National Assembly agreed to the NHI, and in December it was approved by the National Council of Provinces. The Bill is now with Pres Ramaphosa to sign it into law. This bill is a bid to offer “free” healthcare to all citizens. However, it is an unaffordable attempt from the state to drastically cut the income of its citizens.

Constitutionality of one of the elements of the NHI

Solidarity’s court papers are in place for the moment the NHI Bill is signed into law by the president. Moreover, we will again be in court on 4 and 5 June to test the constitutionality of one of the elements of the NHI – the certificate of need required of medical practitioners.

The legislative process to enact the NHI is the easiest, yet most important aspect for the implementation of such a system though. To make it work is the most challenging and critical part of the process. And this is where the process will come unstuck, to put it mildly. Therefore, taxpayers, and especially those who make use of the private healthcare sector, can breathe a sigh of relief (for the time being).

However, if this scheme is fully implemented it could mean nothing less than the destruction of South Africa and its economy. Let’s consider some of the consequences of this proposed programme.

NHI will destroy comprehensive medical schemes

According to Bloom Financial Services, the NHI will destroy comprehensive medical schemes. “Once implemented, medical schemes won’t be able to offer any health services already offered by the NHI. Medical aid will only offer you extra services not covered by the NHI.”

In short, all healthcare funds will be centralised (actually nationalised) in a single state-controlled fund. Given what the government as curator of tax money has caused as a result of blatant corruption and abuse, this is a chilling thought.

Discovery offers further criticism in this regard. “Our strong view is that limiting the role of medical schemes would be counterproductive to the NHI because there are simply insufficient resources to meet the needs of all South Africans. Limiting people from purchasing the medical scheme coverage they seek will seriously curtail the healthcare they expect and demand. It poses the risks of eroding sentiment and of denuding the country of critically needed skills, and is impacting negatively on local and international investor sentiment and business confidence.”

Hurray! No more expensive medical schemes and free healthcare for everyone. Nothing can be further from the truth. The late P.J. O’Rourke once joked: “If you think healthcare is expensive now, just wait ‘til it’s free.” The government will use the NHI as a pretext to impose further taxes, and this has yet to be determined. So, be circumspect with what you agree to and what you celebrate. Presumably, every taxpayer could pay a lot more in taxes only to be caught up in yet another enormous and incompetent bureaucracy, simply to visit your local general practitioner (GP). And your local GP, who is also subject to the whims of this system, will not be paid by the state (just like other service providers who do business with the government), and will decide to emigrate.

Prof Nicola Theron and Dr Paula Armstrong of FTI Consulting recently wrote that to insist that the only path to universal healthcare (UHC) is through a single pool of funds managed by the government and the erosion of the role of medical schemes as purchasers of medical services would probably contribute to the demise of a strong and well-functioning private healthcare section. It narrows consumer choice, erodes competition and may even lead to the same outcomes as recent examples of what has become of state-owned enterprises and funds.

Strong opposition to the NHI

Solidarity is vehemently opposed to the NHI and is strongly in favour of a market approach, offering a choice to private service providers and to the public, as well as being in favour of an improved public healthcare system. NHI will ruin South Africa and Solidarity is preparing for a major court battle to ensure that the healthcare sector is free, safe and prosperous.