In the current context, it takes a brave (read "delusional") government to stand up without a hint of irony or humour in order to state that they will take care of our health, writes Howard Feldman.
The timing is fascinating. If I were a conspiracy theorist, I would've thought that it was designed to fail.
Consider the timing of the National Health Insurance (NHI) discussion. If the ANC were to sit down and try to find the worst imaginable time to launch this initiative, it would be now. With state capture inquiries in full swing, the Public Protector going rogue, state-run Eskom clearly one of the main contributing factors to the downgrades, SAA on the brink, the Post Office all but defunct and the SABC unable to pay salaries without a bailout, it is difficult to imagine a worse time for them have the conversation.
This is a conversation that could have been held anytime in the past 25 years.
Within the current context, it takes a brave (read "delusional") government to stand up without a hint of irony or humour in order to state that they will take care of our health. That all we need to do is pay them and they will do the rest. And that from that point onward, everyone will have access to world class medical care. Perhaps they have taken the judgment on the decriminalisation of marijuana too literally.
Because they are most definitely smoking something.
For the rest of us the mere thought of government being the sole provider of healthcare is enough to raise blood pressure to dangerous levels. With the ANC government in charge of all our healthcare; what could possibly go wrong?
The current bill is ambiguous. Perhaps deliberately, so that it is able to speak to all narratives. That said, the NHI in the imagined form would likely be an unmitigated disaster. The government has proven that they are unable to run a cake sale without stealing the ingredients and have pretty much destroyed every enterprise that they have touched.
The "good news," at least in this sense, is that the ANC has hardly implemented anything in the 25 years that they have been in power. Critical conversations such as land reform continue to go nowhere and vital issues such as Eskom and the supply and deregulation of power continues unresolved. Schools are still a mess with pit toilets featuring in many a venue. SAA continues to dump money like fuel before an emergency landing and the Post Office, in the state that it's in, can hardly manage to successfully deliver a letter.
How then could the implementation of a billion-rand enterprise with the complexity of the NHI and that demands that each citizen and doctor and associated medical services be registered, logged and reimbursed ever come to fruition? Cynically, it would solve the unemployment crises as we are likely to see more deaths than Ebola would cause and more migration than that which occurs in the Serengeti during migration season.
The implementation date of 2026 will never happen. For a more realistic schedule we might look to Eskom's Medupi power station, in which case most of us would likely have died from old age way before this becomes a reality.
Implemented or not, the discussion around the NHI has potential to do damage. Whereas there is little doubt that the NHI is needed in some form, South Africans should have access to decent medical care. But the extreme terms in which it is currently being discussed will discourage our youth from entering the medical field, force our specialists to look abroad for stability and make investors nervous.
Given government's track record and the way in which it has managed public funds and enterprises to date, the best approach is to frame the conversation around that which is practical, that encourages stability and that doesn't do more damage than the good that a NHI could ever do.
PJ O'Rourke summed it up better than I could, by saying, "If you think that healthcare is expensive now, wait until you see what it costs when it's free."
- Howard Feldman is a keynote speaker and analyst. He is the author of three books and is the morning talk show host on ChaiFM.
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