National Health Insurance not a cure all

2011-08-16 00:00

WE’VE all read or heard horror stories about the goings-on in public hospitals that leave us shocked and appalled, so I don’t know anybody that would dispute the need for affordable and decent health care for all South Africans. There is no question about it, the provision of universal access to health care is a right enshrined in the Constitution of our country and, as such, it is the responsibility of government to provide it. I am not convinced though, that the introduction of the proposed National Health Insurance (NHI) is the answer or that the proposed funding model is fair.

First of all, the problem runs much deeper than funding. Nursing used to be a calling — being a nurse is not a glamorous job, it is long hours of back-breaking dedicated caring that can rip your heart to shreds. It takes a very special kind of person to be able to nurse other people, and dedicated nurses have my utmost respect. I would make a horrible nurse (I know this, because I scored 11% suitability when I once did a career profile) and I don’t pretend otherwise. Sadly, many nurses employed in government hospitals see nursing as a job rather than a calling and, consequently, the level of care that is received is often less than satisfactory, and incidents of patient abuse are common.

What is also of concern, is the often less-than-satisfactory management of the current facilities, with blankets and medical supplies being stolen, etc. As a taxpayer, I am assuming that there is also a significant amount of wasteful expenditure, not only in health, but throughout the public sector. (As an aside: our KwaZulu-Natal Minister of Economic Development and Tourism recently announced that the government had to write off R300 million worth of public funds, because the funds were not utilised for the purpose that they were intended for. In other words, the funds were allocated for specific projects, but people who received them utilised them for other purposes.

My point is that throwing more resources at this messy system is sure to result in more mess.

South Africa has a population of 50,5 million people and a tax base of seven million, but according to published statistics, 24% of the South African individuals who are on SARS’s database carry 64% of the personal income tax burden. These are the same people who will be targeted to pay for the NHI. At 40%, the top marginal personal income tax rate for South African taxpayers is considerably higher than the global average of about 29%. How much more can we keep taxing this group of people before they look for greener pastures? How sustainable is this, when unemployment levels are ridiculously high and growing every day?

If we consider that currently one in eight employed people work in the public sector and that the average wage is 44% higher than in the private sector, why don’t we just cut government salaries down to size, manage our resources properly and hold inefficient management and incompetent nurses accountable?

This would go a long way to delivering a better service to all our people. The government needs to get its house in order and perhaps then the private sector might be much more open to the idea of partnership.

• Melanie Veness is the CEO of the Pietermaritzburg Chamber of Business (PCB).

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