The Right to Healthcare and South Africa's Privatization game

Release date

June 8, 2009

Summary

Proposed African National Congress (ANC) health care reform plan released by the Times (South Africa).

Summary by Business Day, 8 June 2009: New health plans 'are unworkable, unaffordable'

IT IS BARELY off the drawing board but opposition is already mounting to the leaked proposals of the government's national health insurance scheme, which is due to be unveiled soon.

If leaked documents reflect the final proposals in limiting the right of people to choose their own form of healthcare, then the private medical aid schemes and healthcare industries and opposition political parties will wage a fierce battle against the proposals. Objections have also been raised within the ruling party itself to what critics describe as an "unworkable and unaffordable" plan.

Health Minister Aaron Motsoaledi told Parliament during Friday's debate on President Jacob Zuma's state of the nation speech the government was determined to introduce the scheme, a draft of which would be published shortly.

Earlier, Zuma told MPs the government would introduce the national health insurance scheme in a phased and incremental manner and that to do so, an "urgent rehabilitation of public hospitals will be undertaken through public-private partnerships".

In terms of the proposals drafted by a task team led by Human Sciences Research Council head Olive Shisana, all citizens would be transferred to a unified healthcare system governed by a single authority outside the Health Department. No one would be able to opt out of the system and employers and employees would bear the costs.

Medical scheme members would pay 85% of their contributions to a general fund that would pay public and private sector providers, and the schemes would be allowed to provide only benefits not covered by the national health insurance. Medical scheme members would be obliged to use state facilities or pay for the use of private facilities from their own funds.

People not members of medical schemes would have to pay 5% of their income to the fund. All doctors would have to move into accredited practices.

But Democratic Alliance (DA) health spokesman Mike Waters said yesterday the problem in SA was not access to public healthcare, which was free to all, but its quality, and here the sore need was for good management.

Before phasing in a national health insurance scheme, "we need to get the basics right" regarding the appointment of good managers at all levels of the health system. "Failing that, no amount of money will be able to improve healthcare," he said during the debate.

Waters said yesterday that if the newspaper reports about the proposals were correct, the DA would be "extremely concerned" as they would represent an attack on private healthcare that would be a "disaster" and would result in a mass exodus of private sector health professionals overseas, not to mention skilled people who valued private healthcare.

Before introducing the scheme, the public healthcare sector would have to be transformed into an effective, efficiently run operation, he said. The government had failed dismally in maintaining standards at state hospitals and should let the private sector manage them.

But over and above this, Waters said, citizens had the right to choose between public and private healthcare if they could afford it.

"Government does not have a right to infringe on this. The rich are already subsidising healthcare for the poor through taxes, and over and above this they are paying for private healthcare. The proposed health scheme looks like the African National Congress wanting to introduce another tax to fund healthcare, and they should be honest about it."

He urged the government to release the proposals as soon as possible and to engage widely on them. He also called for the public release of the costing report from the Treasury, to see whether the scheme was affordable.

Linda Ensor: Business Day, 8 June 2009