WORLDVIEW: The NHI and the myth of private healthcare efficiency

Biznews contributor David Drew recently published an intriguing set of calculations related to the anticipated cost of the proposed National Health Insurance (NHI) scheme. Drew's numbers highlight the dramatic possible scale of the undertaking and also raise important questions about the quality of available data – he seems to have struggled to find relevant numbers, which is worrying from a policy perspective.

However, there is one small point he makes that, I believe, invites further scrutiny. Drew writes, "Now if we assume that public health care can deliver the same efficiency as the private system, which even if we build in the cost/profit of medical aid administrators is a bold assumption, the math suggests that government would need to AT LEAST be spending about R1,000 per person per month for the approximately 46 million people currently relying on the public health system." (emphasis added).

The issue is this: there is no evidence that private health systems are more efficient than public ones. In fact, most global evidence suggests that, if anything, public health systems are more efficient than their private counterparts, as well as less less dangerous for patients.

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