Professor Alex van den Heever of the University of the Witwatersrand has said that the government’s National Health Insurance (NHI) Bill will take 1,000 years to implement as it is “far too complex for this government ever to achieve”.
ENCA interviewed van den Heever after the passing of the controversial NHI Bill by Parliament earlier this week.
He said that the proposals contained in the Bill are financially and institutionally impractical.
The government aims to consolidate the public and private healthcare systems into a single system that does not yet exist.
This consolidation is to be done by a department and a government that cannot run state institutions effectively, according to Van der Heever.
He said it is “far too complex for this government to achieve”. The only reason why Parliament passed the Bill is to give the impression that the government is doing something.
In reality, the Bill is “merely window-dressing health reform and is not substantive”, Van den Heever said. The can will just be kicked down the road, and “nothing of substance will happen”.
NHI in South Africa has become a political tool for the ruling African National Congress (ANC) to score political points and is “not a true, public interest-oriented health reform”.
Government should fix the existing system
Van den Heever said the government has failed to address any of the problems faced by the existing public healthcare system and should first start there.
South Africa’s public healthcare system has the potential to be highly functional and is on par with the best systems in the world on paper.
In reality, the government has failed to make high-quality healthcare a reality for most citizens.
The problems faced by South Africa’s public healthcare system can be fixed without implementing NHI.
Public healthcare in South Africa does not have a structural or resource problem. It has a governance problem, as there is a lack of effective oversight and accountability.
Van den Heever also called on the government to increase the localisation of healthcare systems to ensure that the people on the ground are accountable for their actions.
They should also be given the freedom and responsibility to make decisions without input from the central government.