NHI will chase taxpayers, including doctors, out of South Africa

National Health Insurance (NHI) will cause such a decline in healthcare standards that people will flee the country, warned prominent medical professional Dr Jonathan Witt.

Witt is a medical doctor and Fellow of the College of Anaesthetists practising as a specialist anaesthesiologist.

He is a former President of the Medical Students’ Council and a former Chairman of the Resuscitation Council of Southern Africa.

Witt has worked and consulted extensively across the healthcare industry in training, pre-hospital emergency medicine, and youth enrichment programmes.

This makes him suitable to comment on medical matters, including the impact of the planned National Health Insurance.

Speaking to Sakeliga, he described the NHI Act as an existential threat to South Africa’s healthcare system.

His primary concern is the centralisation of power, which would fundamentally destabilise both the public and private sectors.

The NHI aims to be a single-payer system, which would effectively eliminate private medical schemes and remove citizens’ choice of doctors or hospitals.

Another problem is that a centrally controlled, single-payer system can lead to long waiting times for medical procedures.

“You can still get the medical care. However, instead of two weeks, you have to wait six months,” Witt explained.

He explained that a simple procedure, such as gallbladder removal, could be performed within a week in South Africa’s private healthcare system.

However, in South Africa’s state system, you have to wait on a waiting list, which can mean months before surgery.

For most patients, this will not be a problem. However, a few can develop complications and die. “That is the cost of the NHI,” he said.

NHI will chase people out of South Africa

Witt said that South Africa lacks the fiscal resources and governance capacity of wealthy countries that have attempted models similar to the NHI.

South Africa’s public healthcare system is a good example, where it is riddled with incompetence, corruption, and mismanagement.

Many state-run hospitals are dysfunctional, and South Africans receive poor medical care there.

Witt said the introduction of NHI would sacrifice quality to prioritise universal access, which would impact many people.

It can lead to a system where life-saving technology, like MRI or PET scanners, might no longer be available because the state-set prices won’t cover the costs.

Witt also expresses deep scepticism about the state’s ability to pay doctors on time or at fair rates.

He explained that proposed NHI tariffs for certain procedures are as low as 10% of current private medical rates.

Doctors would also have to apply to a central fund for permission to perform specific tests or use particular implants, removing their professional judgment.

These problems will drive top-class doctors out of South Africa, which, in turn, would impact the medical care citizens receive.

However, it does not stop there. Should the state mess up the private healthcare system, as it did with public healthcare, citizens cannot protect against it.

In most other cases, such as education, electricity, water, and security, people have made plans to do it themselves.

Private education, solar panels with battery backup, water tanks, and private security address state failure in these areas.

However, the NHI, as it currently stands, would prevent the private sector from solving the problems the state creates in healthcare.

The collapse of quality healthcare, which could occur when NHI is fully implemented, would prompt many citizens to flee the country.