National Heath Insurance(NHI) MUST as promised lead to quality health care for all

By Marimuthu Subramoney
(aka Subry Govender)


Seventy-year-old Mrs Kantharuby Mohanlall is a Phoenix grand-mother living in a two-room council home that was left to her by her late husband. She suffers from acute diabetes and other related diseases and does not enjoy the luxury of having any of her immediate family members around.
Her five children have all married and left home.
As a pensioner she is offered the privilege of visiting the local Mahatma Gandhi Government Hospital to collect her tablets once a month.
To do this she has to get up as early as 5am on the specified day in order to be at the hospital at 6am to join the queue to collect her medicines. The only problem is that the queue is so long and the attitude of the nurses and other staff members is so distant and indifferent that she only collects her medicines at about five or six hours after she arrives at the hospital.
Like Mrs Mohanlall there are thousands of other pensioners and less privileged who follow the same routine at government hospitals in Stanger, Osindisweni, King Edward V111, Addington, Chatsworth, Umlazi and other areas.
The quality and standard of service at these institutions have degenerated to such an extent that many people say when a very sickly person visits the government hospitals for treatment they return home in coffins.
It's against this background that one has to analyse and assess the National Health Insurance(NHI) that the government intends to introduce soon to provide universal coverage and access to "QUALITY" medical care for the country's poor.
Briefly in terms of the 59-page Green Paper released by Health Minister, Dr Aaron Motsaoledi, last week all South Africans, irrespective of whether they are members of medical aid schemes or not, will have to subscribe to the NHI and will have to pay a certain amount, depending on their earnings.
Other main points include:
* The NHI will be paid primarily through tax revenue and mandatory NHI contributions. Contributions to NHI will be deducted by employers and employers will also pay into the scheme.
* Pilot NHI programmes will be rolled out first in 10 pilot districts (yet to be named) from next year.
* The public, who will be issued with NHI cards, will be registered from April 2012.
* The estimated cost of the plan is R125-billion in 2012, R214-billion in 2020 and R255-billion in 2025.
Since the release of the NHI Green Paper last week there has been mixed views expressed by commentators and those involved in the private health industry. While some have stated that once again the working population of five million will be burdened with yet another tax, others invoved in the private hospitals have welcomed the NHI and have stated they are willing to contribute to better health care for all South Africans - rich or poor.
But behind the thinking of some of the private hospitals is the opportunity to "cash in on" the billions of rand that the NHI will be dispensing to health care givers.
While one has to compliment the Government for taking the long overdue measure, there are many questions still to be answered as to how the Government will achieve quality health care through the NHI.
Minister Motsoaledi has as a first measure called for co-operation between the public health sector and the private health industry in order to ensure that the NHI is a success. His main concern is that the quality of service at public health institutions must be non-negotiable.
He said: "The challenge and intent of the national health insurance plan is to draw on the strengths of both healthcare sectors to better serve the public."
Despite all the good intentions, one just hopes that the NHI will not lead to nationalised health care where the private health care sector is reduced to the same level as the current degenerative state found in public hospitals.
The NHI must be able to adequately and properly serve the Mohanlalls, the Khumalos, the Celes, the Armstrongs and the Petersons without them having to wait in long queues for hours on end and having to put up with uncaring, unhelpful and arrogant medical staff. - Subry Govender, Chief Editor