Dawie Roodt’s radical plan to improve healthcare for all South Africans

Renowned economist Dawie Roodt proposed a plan to improve healthcare for all South Africans without implementing National Health Insurance (NHI).

On 15 May 2024, Ramaphosa signed the National Health Insurance (NHI) Bill, making it an official law in South Africa despite massive opposition from industry roleplayers.

Election polls showed that the ruling party made a major miscalculation, which cost it support instead of gaining votes.

Political scientist Frans Cronje explained that private healthcare is of value to all sectors of society and that the NHI attacked this right.

Many experts believe that the NHI is dead on arrival as there is no money to implement it and it will be tied up in legal battles for years.

NHI critics, including industry stakeholders like Discovery, have argued that the government’s scheme is unimplementable and unsustainable in its current form.

Roodt said there three reasons why the government’s national health insurance (NHI) scheme will never happen – finances, legal challenges, and ineffective implementation.

“I don’t think it’s going to happen – or at the very least, not the way people think it will happen,” he said. If NHI is ever implemented in South Africa, Roodt said it would likely take decades.

He highlighted that NHI will cost South Africa between R200 billion and R600 billion annually. There is no money in the budget for it.

“The second reason is that there are many legal problems surrounding the NHI legislation. It looks like the government will be in the courts for many years,” Roodt said.

Many organisations, including Business Unity South Africa and trade union Solidarity, have said they will challenge NHI.

“The third reason why NHI won’t happen is that one of the advantages to having a totally incompetent government is that they also can’t implement a bad idea,” Roodt said.

Many believe Ramaphosa signing the NHI Bill into law was an ill-informed political stunt to gain votes.

However, it still leaves the question of alternative ways to provide good quality universal healthcare to all South Africans.

Dawie Roodt’s proposal to improve healthcare in South Africa

Roodt said to improve healthcare, he would use the state money spent on healthcare to create three medical aids and lower the barrier of entry for private healthcare.

“I will break the Department of Health into three parts and transform them into medical aid companies,” he said.

“There should be a law forcing all South Africans to have medical aid. Those who do not have medical aid will automatically become a member of the three state medical aid schemes.”

These three state-owned medical aids will function like any private medical aid scheme, where members must claim money for medical expenses.

The funding will be drawn from the state’s health care budget, which is currently pumped into struggling or dysfunctional hospitals or clinics.

People can use their medical aid benefits to visit any doctor or hospital of their choosing, as long as they have the required benefits to cover the expenses.

If the person does not have enough money through their scheme to cover the expenses for costly procedures, they can visit a university hospital.

“If society has to pay for your medical expenses, you must give something to society. University hospitals mean students benefit from treating patients,” he explained.

The second part of Roodt’s plan is to lower the barrier of entry in private healthcare to create a more open and vibrant medical environment.

“The private healthcare sector in South Africa has far too much protection. It is a bunch of clicks who make a tremendous amount of money,” he said.

The country must proactively lower the quality required to provide private healthcare services to allow more people to enter the system.

“We need to accept that we are a poor country and that it is not possible for us to afford the very high levels of private healthcare,” he said.

The high-quality care at very high prices can remain. However, there must also be a space for lower-quality healthcare at lower prices.

He explained that a simple way to start the process is to eliminate the need for a doctor’s prescription for certain medicines.

Currently, people must visit a doctor, which is very expensive, to get access to a wide range of medicines.

People should be able to take responsibility for their own lives by visiting a pharmacist and buying the medicine they believe they need.