The impact of private healthcare on South Africa's public system

The National Education, Health and Allied Workers Union (NEHAWU) recently emphasised the intricate relationship between South Africa’s public healthcare and private sectors, contending that the operations of one invariably impacted the other.

This notion surfaced as discussions focused on the role of private healthcare in alleviating the strain on an under-resourced public healthcare system.

Nehawu’s spokesperson, Lwazi Nkolonzi, questioned the contribution of the private healthcare sector, which reportedly serves only 20% of the population through medical aid.

He argued that when private patients exhaust their benefits, they often revert to public facilities, further burdening an already overtaxed resource that lacks reimbursement from medical aids.

“The already overstretched public system is then forced to provide care without reimbursement from medical aids, further straining its limited resources,” Nkolonzi stated.

He emphasised the constitutional guarantee of access to healthcare services, asserting that real accessibility was contingent on service availability to all citizens, regardless of their income.

Nkolonzi lamented the exorbitant costs associated with private healthcare in South Africa, noting that it ranked among the most expensive in the world, making it unaffordable even for those with medical insurance.

This perspective was echoed by Busi Roberts, Head of Marketing and Communication at Umvuzo Health, who highlighted the valuable role private healthcare played in managing patient overflow from public facilities.

Roberts asserted that by addressing the healthcare needs of 20% of the population who choose private options, the private sector helps to decrease pressure on public resources, ensuring faster treatments and alleviating congestion in government hospitals.

“Accessible private facilities allow earlier diagnosis and treatment, which can prevent the escalation of illnesses and reduce the severity and complexity of cases that eventually reach the public system,” she stated.

However, Nkolonzi rebutted Roberts assertion, and argued that the high costs of private healthcare undermined constitutional rights and exacerbated the pressures on the public sector.

“In a country grappling with high unemployment, rising inflation, and extreme income inequality, only a small portion of the population can afford private healthcare,” he claimed.

He described the private sector’s operation as largely profit-driven, criticising its commodification of healthcare which limits access and encourages unnecessary procedures.

Nkolonzi pointed to findings from the Health Market Inquiry, revealing systemic inefficiencies and ethical dilemmas within the private healthcare framework.

Despite a small percentage of the population, he highlighted that South Africa allocated a disproportionate amount of its health expenditure to private voluntary health insurance, making it an outlier in global health systems.

“Even with all the resource concentration, this does not translate into better health outcomes, which indicates a system focused more on quantity than quality,” he said, underscoring that healthcare access was predicated on affordability rather than medical necessity.

In contrast, Roberts maintained that private healthcare should be regarded as a partner in enhancing the national healthcare landscape. She advocated for collaboration and innovation between private and public sectors to promote quality care as a universal right rather than a privilege.

“By shouldering part of the load, fostering innovation, and working collaboratively with the public sector, the private health industry can help ensure quality care was not just for the few, but a reality for all South Africans,” Roberts stated.

Expert opinion from Professor Saloshni Naidoo from the University of KwaZulu-Natal suggested that while public-private partnerships were worth exploring to alleviate the public sector burden, careful supervision and monitoring were essential for their success.

“One can consider public-private partnerships. This will help alleviate the public sector burden. However, this has to be properly monitored to ensure we are achieving these aims,” Naidoo explained, recognising the potential but cautioning against unregulated expansion.

DAILY NEWS