I watched the dialogue on our ailing health-care system on eNCA, and wondered how the audience, after pointing out the many serious problems and challenges that have brought our service to its knees, could conclude the only solution would be the implementation of National Health Insurance and universal health-care coverage.
To highlight a few problems that were raised: lack of resources such as equipment and medication, mismanagement of health facilities, underfunding of all health institutions, procurement problems and corruption.
Staff shortages, with the South African Nursing Council showing that the nurse-to-patient ratio is one nurse to 218 patients: a recipe for medical negligence claims. In ICU, the correct ratio is 1:2 and in an emergency it is 1:4.
Crumbling infrastructure, inadequate training of all categories of health professionals, increased burden of disease, ballooning medical negligence claims, disparities between public and private healthcare provisions, and the list goes on.
It was unanimously agreed the only solution was the implementation of the NHI and universal health-care coverage.
Do we even understand what all this entails, and its implications?
The NHI funding is derived from employee and company taxes. For instance, in the UK in 1998, the conditions of employment stated 25 % of my salary would be deducted for pay as you earn and 9% for NHI, a total of 34%. The UK has an unemployment rate of 3.5% and its NHS is also supported financially by the thousands of expatriates who work there, but its universal healthcare system, the NHS, is struggling with many problems.
South Africa, on the other hand, has poorly resourced and poorly managed health services exploited by millions of foreigners from neighbouring countries, with a high unemployment rate standing at 33.9%. That means we have a small tax base that can never provide sustainable funding for universal health-care coverage.
Implementing universal health care would be disastrous, collapsing what we have and following in the footsteps of Zimbabwe.
Is that what we want? We are in a position to learn from the successes or failures of others. Cuba has a long history of a universal health-care system but is struggling to sustain it, depending on its diaspora working in other countries for aid.
* Cometh Dube-Makholwa, Midrand.
** The views expressed here are not necessarily those of Independent Media.
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