No class bias: NHI is a plan to close the gap in healthcare between the rich and poor.
If the 2 800 white farmers, who collectively owned more than 70 percent of the most arable land in Zimbabwe had embraced the fact that owning land while millions of indigenous people remain landless was unsustainable and had been proactive in finding creative solutions to address the land question, the economic melt-down in that country could have been averted.
But no. They believed social injustice can last forever. They believed in their lie that the African majority were only interested in political power and nothing else. They made an error of judgment. The liberation struggle against the Rhodesian regime of Ian Smith was to repossess the land that was taken from the indigenous people by mainly British settlers.
Yes there was euphoric celebrations on April 18 1980 when the new government of revolutionary leader Robert Mugabe hoisted the new Zimbabwean flag that marked independence from British colonial rule. But democracy and black majority rule did not bring social justice and most importantly, it did not address the land question – the primary source of the conflict that gave rise to Chimurenga, the liberation war.
But hunger for land for the majority of Zimbabwean people could not be suppressed forever. Around the year 2000, war veterans, many of whom had been discharged from the Defence Force, after the ZANU-PF government was trying to reduce state expenditure as per the prescripts of the International Monetary Fund and the World Bank, regrouped and formed a pressure group, National Liberation War Veterans Association, under Chenjerai Hunzvi to force the government to address the land question.
The war veterans confronted the government about the land issue which had not been addressed 20 years after independence. The ZANU-PF government responded by directing the war veterans to the handful white farmers who owned most of the land in Zimbabwe. Under escort of the security forces, the war veterans invaded white-owned farms and physically drove the white farmers off the land.
The failure of the government to protect property rights triggered a total collapse of the Zimbabwean economy. Within months of the land invasions, inflation in Zimbabwe was expressed in millions. The currency collapsed. Zimbabweans became billionaires overnight but they could not afford the most basic needs including food. Many of them fled the country and settled in other countries including South Africa and Britain where they still live even to this day.
The so-called third Chimurenga produced no winners. Only losers. The white commercial farmers lost the land they had been working on for decades. Farm workers lost their jobs. Because of the anarchy that characterised the land invasions, the new land occupiers failed to use the land effectively. The economy, which was supported in part by the export of tobacco, collapsed. Western countries led by Britain and the United States imposed sanctions on Zimbabwe, making a bad situation worse.
Thoughts of the tragic developments of Zimbabwe were triggered in my mind by what was happening in the Constitutional Court this week. A section of the propertied class in different guises but primarily the beneficiaries of the current unjust healthcare system, has taken the government to court in a bid to stop the implementation of the National Health Insurance (NHI).
The NHI is anchored on the principles of Universal Health Coverage, which seeks quality health care for all regardless of economic or social status. Because of its noble-idea status, NHI is difficult to be opposed openly.
The opponents of NHI argue that the government should leave the private healthcare system alone and instead improve the public healthcare system by funding it properly.
But what are the facts?
The World Health Organisation recommends that a country should spend 5% of its GDP on health. South Africa already spends 8,5 percent of its GDP on health, meaning that the problem is not that health does not get its fair share of funding.
The real problem is that South Africa spends to much money on too few people.
Of the R570 billion spent annually on healthcare, 51% goes to 14% of the population while the remaining 49% of the funds goes to serve 86% of the population.
The country is spending too much money on too few people who have medical aid.
Signs of political instability are brewing. Over the past few weeks we have witnessed marches in different townships where residents are demanding the mass deportation of illegal foreigners.
In some areas, local residents have prevented foreigners from accessing healthcare in public facilities. It is clear that the public healthcare system is under severe strain, partly due to a lack of funding as the lion’s share of the funds allocated to healthcare in the country is spent on the minority that have medical aid.
Another false argument is that those who are on medical aid are using their private money. The fact is that the State spends R70 billion in subsidy to public servants, politicians and Members of the judiciary.
Furthermore, the State grants tax rebates or credits of R33 billion to those who are on medical aid.
In total the State allocates more than R103 billion to those with medical aid. The reality is that the State is granting subsidies to those who are financially better off.
This is what the NHI seeks to do away with. NHI is a common fund that will fund our healthcare needs in both the public and private sector without regard to the economic status of the patient.
How can anybody want to oppose a plan that seeks to end inequality in the provision of healthcare? This is why those who oppose it do so on technical grounds. They argue that proper consultations were not done. But even if consultations had been done, the plain truth is that they would still remain opposed to the NHI.
They argue that there is no clarity on how NHI will be funded. They even go to the extent of stating that it will bankrupt the country. But if they were honest, they would say that they are opposed to NHI because it has a negative impact on their businesses.
Former President Thabo Mbeki once described South Africa as a country of two nations: One black and poor and the other white and rich. South Africa is reputed to be the most unequal society in the world. NHI is a plan to end the gap of healthcare between the rich and poor.
Those who are interested in a stable and prosperous South Africa should learn from what happened in Zimbabwe. It is important to avoid creating a fertile ground for extremists who thrive by exploiting fears of the majority.
Some of the extremists argue that our Constitution is a creation of the oppressors of yesteryear to circumvent the will of the majority and undermine democracy. If the Constitution can be potent tool to stop a noble idea such as NHI, how can it be trusted to address other legacies of settler colonial rule such as the land dispossession and economic exclusion of the black majority.
While the section of the propertied class has access to the highest court in the land and can effectively derail the implementation of laws designed to create a more equal society, they must think deeper and for the long term.
They should heed the advice of the former Minister of Foreign Affairs Pik Botha when he warned: South Africa is like a zebra. Whether you shoot a black or white stripe, the animal will die.
Indeed the country will only be stable in the long term if the fears and aspirations of the majority are paramount. The opposition to NHI by the propertied class is not an isolated issue.
It is part of the broader strategy to retain privileges and benefits attained under apartheid. Little wonder that South Africa has become the most unequal society in the world. The poor continue to be marginalised and any efforts to bring equality are ferociously fought by those who have the means to approach the courts.
The propertied class should remember the words of Chinese military strategist Sun Tsu when he said, when you corner your enemy, offer him an escape route.
The majority of the people may not have the millions of rands to take their issues to the Constitutional Court but failure to create a caring society, where the majority become beneficiaries of the dividends of freedom and democracy, will produce a similar tragedy such as Zimbabwe. When this happens, there will be no winner.
Khathu Mamaila is a former newspaper editor.