Hold tight to Tito

His grey-at-the-temples eminence, wordy internet epistles and penchant for appointing sycophants sucked all the life from politics.

President Thabo Mbeki presided over a rather grey administration. He encouraged people to speak like him, dress like him and think like him. We have no problem with his dress sense, but it did give rise to a monochrome Cabinet. The groupthink he encouraged has been disastrous for our country.

This has had an effect on public life, where Mbeki’s administration and his ruling party revealed few great minds, bright sparks and mavericks.

It is for this reason that we support the retention of Reserve Bank Governor Tito Mboweni. That scourge of the photographic corps given to long treatises on the delights of avocado farming and the greater delights of Cohibas and red wine is certainly a colourful public figure. Urbane and articulate, he does things his own way and has never been afraid to speak out.

Yes, he is the world’s most hawkish central-bank governor and this is an instinct he will have to modify should he get the nod from the radicals about to storm the ramparts of the Union Buildings next year.

His inflation targeting band is too low, though the idea that we should target a rate is not a bad thing.

It’s worth noting that Mboweni has not always been this way. He likes to forget it, but he was the midwife of the radical labour laws that have been the greatest gift to the working class since Karl Marx. Thus, he is not a natural hawk.

Mboweni would bring a welcome dose of stability to the changeover of 2009 and if monetary policy is altered to ensure that its effect on the poor is less harsh, he will have to implement it. His ability to take unpopular decisions means he is not a populist in an era of rampant populism and he enjoys the political gravitas that will make him an equal of the incoming leadership of the ruling party.

The governor has long said the position he covets is ambassador to the “court of St James” — that’s the United Kingdom to the rest of us. He should hold fire. We in the court of Jacob Zuma should hold tight to Tito.

From beetroot to baloney?

South Africa does not need a new round of health-policy madness so that we lurch from beetroot to baloney.

We need a functioning public-health system alongside the private medical aid industry while we embroider the cloth of a national health insurance scheme, which the country sorely needs.

Both the private and public systems require urgent changes, but neither can be thrown out without endangering that most basic right — effective healthcare.

Private practice drains resources from the state’s institutions but this situation is exacerbated by appalling management across all levels of public sector healthcare.

The ruling ANC established a committee earlier this year to consider different options for national health insurance, which would provide a minimal package of care for all South Africans.

Worldwide there are many permutations of this concept, some of which are applicable to a middle-income country like South Africa which has vast disparities of income, and others that are not.

One perspective out of Cosatu is to divert all the healthcare resources — financial, human and institutional — into the public sector. The union federation wants to end private care while diverting 8,5% of GDP to a single agency attached to the health department. This agency would be a centralised authority for healthcare.

In an ideal social democracy it is sensible to downsize for-profit health as much as possible, while making the public health system the best resourced system in the country. It is not going to work in our country because of historic dysfunction and current crises.

Cosatu’s timelines are unrealistic and its plans would harm the entire system just as pressure is removed from public care as the numbers of people joining medical aid schemes is growing.

This increase in medical aid membership has largely been driven by the Government Employees Medical Scheme, which provides access to private healthcare for civil servants who previously would have been stretched to afford medical aid premiums, even with an employer subsidy. These are the working poor, who need health protection both as individuals and as parts of the national economy.

People outside formal employment also need access to decent healthcare as fast as possible, but the way to ensure this needs to be logical and achievable without removing such access from those who already have it.

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