NHI will lead to healthcare collapse, drive doctors abroad: Woode-Smith

National Health Insurance (NHI) will harm South Africa’s healthcare, likely bankrupting the fiscus and degrading private healthcare to failing public levels. Doctors distrust the system and are leaving the country. Despite government claims of fairness, medical professionals see NHI as an election ploy and a cover for corruption. Effective healthcare reform should focus on improving the current public system and collaborating with the private sector.

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By Nicholas Woode-Smith*

National Health Insurance (NHI) will not improve South Africa’s healthcare system. Instead of enabling the poor to access high quality healthcare, it is much more likely to bankrupt the fiscus, while tearing down competent private sector healthcare until it is at the level of failing public healthcare.

For this reason, the uncertainty surrounding the NHI act, and its multi-level threats to the medical aid and healthcare industry, many doctors and healthcare professionals have fled or are aiming to leave the country for greener pastures.

Health Minister Joe Phaahla has urged healthcare workers to not “be swayed by fearmongers”. The government wants to push an idea that NHI is about solidarity, unity, and fairness. But doctors are far too smart for such propaganda.

The South African Medical Association (SAMA), the Solidarity Doctors’ Network (SDN), and Business Unity South Africa (BUSA) have all expressed worry that NHI will chase medical practitioners out of the country. Doctors don’t trust the system and do not want to comply with what they believe to be an ill-thought-out attempt to hide corruption behind the veneer of universal healthcare.

SDN’s research shows that medical professionals do not support NHI. They think it is an election plot, and that NHI will further deteriorate conditions for South Africans.

The Solidarity Research Institute (SNI) found that 47% of doctors would start the emigration process as soon as NHI was accepted, while 19% had already begun the process. A whopping 0% of medical practitioners are optimistic about NHI.

Minister Phaahla is disingenuous to paint the threat of a medical exodus as mere ‘fearmongering.’ Doctors don’t trust the government, and they don’t believe that NHI will work. The healthcare sector is built on doctors; without them, there is no healthcare. So, they should have a say in how the healthcare system is structured and implemented. And they have made it clear that they will not abide by NHI.

The government can’t even get the public healthcare system to work in its current form. As it stands, the public healthcare system is funded by taxpayers, and doesn’t even need to serve a large portion of the population – as they are willing to pay for their own healthcare elsewhere. NHI would multiply the tax burden on an already strangled tax-base, while also forcing everyone under the same system.

Public hospitals and clinics are so mismanaged, understaffed, underequipped, and plagued with corruption and incompetence already – imagine if they could no longer rely on the private sector to pick up the slack.

Already, the government doesn’t have enough money to even hire enough medical graduates for the public sector. Yet they believe they can force all doctors under a bankrupt, corrupt and mismanaged single system?

If I was a doctor, and I saw the government failing to pay my public sector counterparts, and then I learnt that they were going to force me to become a public sector doctor, I’d be trying to leave the country too!

NHI is just another symptom of the ANC’s endless need for control, blended with an ambitious incompetence with no foot in reality.

Instead of creating a mammoth system that nobody actually wants, why not try to fix public healthcare as it stands now? Work with the private sector rather than resent and destroy them.

Allow the private sector to ease the burden on the public system by deregulating private healthcare to enable more private hospitals and clinics to be founded, raising the supply and capacity. This increased supply, on top of eliminating unnecessary regulatory burdens, will also enable facilities to charge lower prices for treatments – allowing more and more people to be cared for by the private sector.

On top of this, incentivise the creation of private sector specialised medical schools to churn out more and more doctors, while reassuring doctors that they will be able to work in the institution that they desire without fear of being placed in a nationalised, corrupt system.

NHI is not what this country needs. It will devastate the only parts of this country’s healthcare system that do work. If the government wants equality, NHI will only accomplish it by ensuring that nobody receives quality healthcare. No reasonable person should be aiming for that.

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*Nicholas Woode-Smith is a political analyst, economic historian, author and associate of the Free Market Foundation. He writes in his personal capacity.