'NHI won't happen because this govt can't organise anything' - economist

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“Just relax, NHI is not going to happen.” Those were the words of economist Dawie Roodt this week as South Africans went into panic mode following the tabling of the National Health Insurance bill in Parliament. Twenty-five years since the idea was first mooted, the government announced the National Health Insurance scheme, its new health funding mechanism, would come into effect in 2026. This was to equalise access to health care for all South Africans and do away with medical aid in its current form. Under the new model, public health patients could end up in private hospitals and private health patients in public health facilities. The news saw many health professionals weighing up their options between staying or moving abroad, while unions welcomed what it called a pro-poor policy.

However, Roodt said that to implement the NHI the government would need plenty of money, which would place a bigger burden on its already strained coffers.

“The NHI will not happen because this government just cannot organise anything. They are not going to get things right in time,” said Roodt.

He said the government needed to cut state spending by 15% or R200billion to stabilise its debt.

Therefore, said Roodt, the billions needed to fund the NHI did not exist and no country or institution would lend South Africa that amount.

“Even without Eskom, the debt levels of national government will exceed 60% of the gross domestic product,” he said.

Roodt said the NHI would only come into existence if the government expected the private medical industry to pay for it.

He said the scheme was forcing doctors to work for the government and patients to go to doctors chosen for them.

“If you force everyone into one camp and tell them to work for the NHI, a lot of doctors are going to say goodbye.”

“It’s complete madness. It’s going to run into a brick wall somewhere.”

Roodt said if the NHI were implemented it would fail and the government would blame it on the “capitalists and doctors who ran away”.

He said a few “sane” people had probably been kicking the NHI “can” further down the road, but he suspected that President Cyril Ramaphosa had used it as a bargaining chip.

Heinrich Volmink, the executive director of the Organisation Undoing Tax Abuse (Outa), said it believed in the need for universal health care and equality of care for everyone, but was concerned by the bill in its current form because the government wanted to build a colossal system on the back of one that was already broken.

Volmink said Outa would meet several experts in a range of fields and then give South Africans a chance to share their views in a public participation process.

“Parliament will need the public behind it to ensure success,” he said.

He said while social justice and equity in health care was essential, everyone needed health care that did not put them in financial risk.

Some of Outa’s concerns include how the committee overseeing the NHI would be composed. Volmink said the NHI pilot sites had not been successful and that his organisation would be giving a “substantive set of recommendations” to the state once its consultative process was complete.

Sunday Tribune