MICHAEL MORRIS: NHI is a long way off — if that makes you feel any better - Business Day
Michael Morris
The average person will doubtless find it as hard as I have to imagine a doctor telling a patient with obvious signs of a life-threatening condition that there is no reason to take any immediate action since the dread outcome is not likely to manifest until some point far in the future.
“It’s a long time before it is a reality,” such a doctor might tell the patient. “At this stage, there is no need to panic.” Is this the sentiment of an indifferent medical professional, or is it the reassurance that’s legitimate, even palliative? How could we expect the patient to see it?
I am not, of course, thinking of a literal doctor and patient as attentive readers will know, though a medical analogy is wholly fitting. The quoted words in the second paragraph above were spoken last week by Discovery Health CEO Ryan Noach in a television interview with Newzroom Afrika on the risks posed by the National Health Insurance (NHI) system.
This was just a matter of hours after the National Health Insurance Bill had been given the green light by ANC MPs in the National Assembly. The draft law’s final and likely not-terribly-demanding hurdle will be the National Council of Provinces. Was Noach worried, anchor Xoli Mngambi wanted to know, about warnings that the NHI would “decimate the private healthcare sector”?
Well, sort of, but not really. Dr Noach’s opening words were unequivocal: “That sounds like a panicky reaction, and to be quite clear we are not in a panic about this.”
To be fair, Dr Noach was candid about what he saw as the “biggest risk” posed by the bill, this being the negative sentiment it had generated in the healthcare sector, the fact that “doctors are really very concerned”, and the risk of a brain drain, or “loss of capability”, arising from health professionals emigrating because they were “very concerned” about the future of healthcare in the country.
While he hinted at some apprehension over the absence in the NHI schema of anything approaching sane financial modelling, it’s fair to say Discovery members will not be alone in hoping Noach is right that the idea of the state “nationalising” medical aid funds would be “completely beyond the realm of realistic thought”. But this is precisely the worry. Much of what the ANC has done, and continues doing — especially as it weakens — is indeed completely beyond the realm of realistic thought.
As Tim Cohen wrote in Business Maverick last week, the National Health Insurance Bill is one of three pieces of legislation the ANC “has just passed, or is about to pass ... that suggest it has completely lost its grip on reality”. (The other two were the Employment Equity Amendment Act and the National Water Act.) All of this legislation, Cohen remarked, “is so gratuitously inept there will be court cases up the wazoo. They may help the situation or perhaps just delay it. Who knows?”
Health minister Joe Phaahla, who calls the National Health Insurance Bill “one of the most revolutionary pieces of legislation presented to [parliament] since the dawn of democracy”, demonstrated a rock-solid commitment to a single mega fund for all healthcare when he told MPs: “You either have a national system of solidarity and a shared pool of funds, or you keep what you have... A multi-entry or multi-system of insurance would defeat the (purpose of an NHI). In our view, from a policy perspective, you make a choice.”
Doubtless, this is all a long way off — but is the distance really reassuring?
Morris is head of media at the SA Institute of Race Relations.