Healthcare Hurdles

I am writing this article on the morning of budget day. One of the topics which feature quite heavily in pre-budget speculation concerns progress on the planned National Health Insurance (NHI). Of even more importance to the country is what the real cost is going to be, and where the money will come from to pay for it?

Already, we see that the few are taxed to fund the masses dependent on government allowances to survive. Whatever the reasons for this, (and there are many, depending on your political persuasion) it cannot continue unabated.

Mike Schussler of, is quoted in an article in Mail & Guardian as saying:

“We have an extremely narrow tax base that we are trying to do a hell of a lot with and we are not succeeding.” Schussler added there was an “unsustainable reality”, where too few taxpayers were already supplying for too many citizens exempt from tax through miniscule salaries or unemployment. “South Africans can’t continue paying taxes for the masses who are unemployed. Government needs to get those people working,” he added. “If there are no measures in this budget to address these problems, we will be scrambling to plug holes we simply can’t fill through tax hikes.”

Very few people have a principle problem with the NHI. It is practical issues, and specifically funding, which raises doubt in the minds of realists.

The headlines in my newspaper this morning concerns the eNaTIS project which now costs three times the original projection. Dating as far back as the weapons scandal, it has become almost standard practice for budgets to be submitted, only to see it inflated by, amongst other reasons, the sno(u)ts in the trough of self-enrichment.

But this article is not really about the NHI and its ideals. It is about people on the ground being disadvantaged by those in power.

Gap cover provided a safety net for those unable to afford the massive increase in private healthcare provision over the years. The efforts by the authorities to have it squashed, makes one wonder if there are not other motives for the vehement attacks, rather than just blurring of the distinction between two pieces of legislation.

The latest farce concerns DomestiCare, a product aimed at assisting domestic helpers, who are among the lowest paid people in the country, to gain access to better medical care than available at provincial hospitals and clinics. For as little as R170 per month, the domestic worker gets access to a comprehensive range of medical facilities. In fact, it beats the benefits of a full blown medical aid, in some instances.

Rather than encourage employers to help their employees by making such payments tax deductible, the Council for Medical Schemes regards it as a way of sidestepping legislation and wants it banned.

CareCross, in turn, says it is a professional healthcare solution which falls outside the ambit of both Short-term Insurance and Medical Funds legislation.

Why the Medical Schemes Council deems it necessary to object to products which allow access to primary healthcare to many who would otherwise not be able to access it, boggles the mind. The NHI, if and when it becomes fully functional, is still years away. Must these people therefore be deprived of such benefits purely because of possible red tape?

Why do the authorities not encourage behaviour of this nature from the private sector? Are they afraid of being shown up, or jealous for not having thought of it first?

While they are busy building a pie in the sky which will most likely be inedible, they are hampering those who are prepared to bake bread for the hungry people down on terra firma.

But then, only one as naïve as I would expect logic from politicians that would make sense in this crazy world we live in.

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