/ 21 January 2016

Editorial: Disarray bodes ill for NHI

The new Natalspruit Hospital is a sign of things to come
The new Natalspruit Hospital is a sign of things to come

Universal access to healthcare could be of immense benefit to South Africa. Research is clear that countries with well-implemented government health insurance schemes have significantly better health outcomes than those with purely market-driven systems.

But efficient management is key. Good intentions are not good enough.

At its core, a national health insurance (NHI) scheme is about the efficient administration of large amounts of money. How a government deals with corruption at a senior level is a good indicator of whether such a scheme will succeed or fail. At present the public health systems in the Free State and Mpumalanga are in disarray, and the government’s general record on corruption is not exactly encouraging.

Health industry players are also rightly anxious about the recently released NHI white paper’s calculations regarding the costing of the scheme. Many consider the figures presented in the document as far too low and not thoroughly thought through. The white paper, for instance, lacks details about precisely what services will be included in a “comprehensive package”, which will greatly determine its cost.

A conservative costing approach may be politically expedient but it bodes ill in the long run.

South Africa has a long way to go before it will be ready to implement affordable access to healthcare for everyone. If the government doesn’t put drastic measures in place to address the gaps in how its public healthcare system is managed, the NHI will either not see the light of day or become financially unsustainable soon after its start.