Empty trolley beds inside a clinic in Alexandra (Guillem Sartorio/Bloomberg via Getty Images)
There aren’t many places where South Africans from all walks of life meet. A poorly planned public transport system from the 1950s and apartheid spatial planning have all but ensured class and racial segregation. The disruption of the public schooling system by the proliferation of private schools has further exacerbated our differences. Healthcare has also served to heighten inequality and division in the country because only 16% of us have private healthcare, while the majority rely on a creaking but still functional public healthcare sector.
Maladministration – and the confidence sapping headlines it breeds – in our public sphere has proved fertile ground for “The Great Escape” to the private sector. For many of us, the social contract is broken, but only a few can afford to navigate their way out of dependence on the state. Solar panels, private schools and clinics are being built across the country, access-dependent on which side of the track you are on. Whatever metric you use to dictate the success or failure of a nation, our current path isn’t sustainable.
Being South African, with all the history that comes with it, means that those among us who choose to be conscious must at all times seek to pursue social justice — the fair and equitable division of resources, opportunities and privileges in society.
No matter what sphere of society we come from, whatever the politics taught to you, there’s no escaping the fact that in 30 years of political freedom we haven’t done enough to undo the social injustices that were served to the majority.
The Mail & Guardian chooses to highlight “social justice” as the debate around National Health Insurance raises its head once again. It’s a topic that has lingered over the past 20 odd years. There’s a painfully slow march towards it – slowed by an incapacitated state, whose best and brightest administrative minds are poached by private sector players. It doesn’t help that we haven’t been blessed with the best health ministers over the past 30 years. Names such as Manto Tshabalala-Msimang and Aaron Motsoaledi come to mind. As health minister, Zweli Mkhize seemed to have staged a political comeback in the country’s successful response to Covid-19 pandemic, only to be undone by the corruption demons of his past.
Despite our fears of governance of the NHI being driven by fears of corruption and limited state capacity, the issue of equal access to healthcare for all cannot be dismissed by the fear of what the 16% may lose in a shift to the NHI. We need to grapple with the concept and look at governance models that would ensure the safety of our healthcare system. Institutions such as Chris Hani Baragwanath Hospital need our help if it’s going to continue to serve the people. The NHI, much like the basic income grant, is an important economic consideration for the treasury regardless of how broke and desperate the department may feel. It’s not a vanity project — future generations will thank us.