Editorial: Get real about this NHI utopia

No rational person is against all South Africans enjoying efficient, good quality healthcare, no matter how poor they are.

It’s the dream, right? Especially in post-apartheid South Africa, where the public health system has been allowed to degrade over the years – infrastructure is crumbling, there are shortages of staff and life-saving medicine, and rank mismanagement.

The National Health Insurance (NHI) system was hailed as the cure for these ills.

This month, the NHI Bill was adopted by Cabinet, bringing it a step closer. This week, the Presidential Health Compact was signed, a blueprint for how healthcare in the country must be fixed.

NHI, or universal health coverage, isn’t unique to South Africa – it is one of the UN’s sustainable development goals, which states that, by 2030, all member countries should provide financial risk protection, access to quality essential health services, medicines and vaccines for all.

The UK, Japan and France all have it.

But we have a long way to go. The release this week of the Genesis report the health department commissioned into the first of NHI’s three phases showed a mixed bag of weaknesses and successes.

The extremely expensive private healthcare sector is balking at NHI, but cannot throw stones. Last year’s health market inquiry found it was “characterised by rising costs of healthcare and medical scheme cover”, and by “disempowered and uninformed consumers”.

South Africa’s entire health system leaves a lot to be desired, and government needs to get real and stop the rhetoric about a utopian healthcare future.

If people saw a difference in services currently offered, did not have to wait hours for treatment at clinics and hospitals, or months or years for surgery, and if babies weren’t dying during birth, that rhetoric would be more believable.

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