Like most concerned South Africans, I have been paying a lot of attention to the governing party’s resolute plans to take control over the health care system in SA with its National Health Insurance scheme (NHI), despite overwhelming opposition from almost all sectors of society.
Just think about it: a government which has trashed just about EVERYTHING they have ever got involved in is now hell-bent on taking control and becoming the only player in SA that provides medical care from dispensing a single headache tablet to a complex brain surgery, and everything else in between.
Let’s first look at the long list of current ANC successes we have witnessed over the past number of years:
*Collapse of the railways system.
*Collapse of ESKOM.
*Near collapse of SAA.
*Collapse of the SA Post Office.
*Bankruptcy of almost every single State- Owned Enterprise.
*Collapse or near collapse of SA road system.
*Collapse or near collapse of ports and harbours.
The most telling comment I’ve read comes from the straight-shooting Busi Mavuso, CEO of Business Leadership SA (BLSA) who wrote on Moneyweb this week: “The NHI charade continues despite its absurdity.”
“I can assure you that it will end up in no improvement to the health care quality in South Africa, in fact, the risk is precisely the opposite. We continue with this make-believe in which the apparent upsides to the NHI-access to quality health care for all—can be talked about without ever having to discuss the practicalities.”
“That way, the core-yearning fantasy can be sold to the public without any of the vote-destroying realities of it, particularly how it will be funded and the devastation to be dealt to the private health care industry.”
Destruction of medical aids
It is specifically the destruction of the current state of the medical aid system that worries me, imperfect and expensive as the system might be.
But it remains a fact that almost 9 million people in SA are on medical aid schemes, one way or the other. This is by and large people who are fortunate to be employed in SA but also pay the bulk of taxes in the country.
Ah, says the socialist/Marxist commentators” “That is unfair to those who cannot afford world-class medical treatment and must rely on the state for their mostly free medical care.”
So, the answer is if everyone cannot have it, no one will have it. The dumbing down of medical care will be the end result.
But we know how that works out for most people. While there are very good state-run hospitals, they tend to be in the Western Cape, run by you-know-who.
Prof Alex van den Heever, Adjunct Professor at the Wits School of Governance, has repeatedly pointed out that the funding of the NHI is problematic. In fact, he says, it is unaffordable and will place a massive financial burden on an ever-shrinking tax-paying population.
VAT would have to increase to 21% and personal income tax to as much as 50% and more to fund the expected R250 billion-R400bn this will cost annually. At best this is a wild guess because the financial estimates are very thin on the ground.
A recent interview by Alec Hogg of BizNews with Dr Nicholas Crisp, acting deputy director general at the Department of Health and the man tasked with implementing the NHI is very telling and also very chilling.
After a long and rambling argument in favour of centralised planning and State control over almost all aspects of the health-provision chain in SA, Hogg asks about cadre deployment (and the consequences thereof).
Career-civil servant Dr Crisp, smooth as silk, dodged the question and said: ”I prefer not to comment on politics as I have no involvement in that sphere”.
One can only but say to Dr Crisp:” EVERYTHING in ANC-controlled South Africa is about politics and you should be aware of it”.
I thought old friend Hogg had a massive opening but for some reason let it slip. A few seconds later Dr Crisp contradicts himself by admitting that political interference does play a role in the poor outcomes being experienced in the public health sector.
One can only but roll your eyes at such naivety about the role of cadre deployment, BEE-tenders and even a Medical Mafia in future stalking medical contracts, such as is happening in the construction industry today.
For many upper-middle-class to wealthy South Africans who have not considered emigration, the spectre of an ANC-controlled and managed NHI scheme might just be the final straw.
In Brenthurst-offices countrywide the issue of emigration – increasingly by doctors and medical specialists – is being discussed with increased regularity.
Feelers are quietly being extended in order to enquire about positions in Australia, New Zealand, the UK, Canada and even Mauritius.
My Mauritian experience
I have just undergone a total hip transplant in Mauritius and the experience is on par with that of SA in terms of the surgeon’s skills. I even thought the aftercare in the Wellkin Hospital in Moka was better than a previous experience I’ve had in SA.
That got me thinking. With so much uncertainty and with such a wide range of potential outcomes regarding the future of medical treatment in SA, I’ve decided to set up a special medical trust in Mauritius, which I will fund annually with my R1m single discretionary allowance.
I will continue with this for as long as I can. I have even changed the beneficiary of my Discovery Global Life Policy to this trust.
The objective is to create a legal and financial vehicle that will take care of my family’s future serious medical expenses, far away from the greedy and grubby hands of the ANC.
The trust deed and letter of wishes make it very clear that the money (a) will be invested in a global investment portfolio and (b) will, at the discretion of the trustees but under clear direction from the letter of wishes, be used for the medical care of my children and grandchildren in Mauritius.
I think that over time this will become my biggest legacy, not to be spent on houses or cars, but something very worthwhile and enduring.
I used a trust management company called Brent Consulta on the island to set up the trust. Brent Consulta is an associate company of the Brenthurst Group.
*Magnus Heystek is a director of Brenthurst Wealth. Brenthurst Wealth has recently been voted as the runner-up in the Top Boutique Wealth Manager category in the 2023 Intellidex Survey of private banks and wealth managers.