Legalbrief Today quotes from a Sake24 report which says that hospital groups are delaying the issuing of a White Paper on the National Health Insurance Scheme through their ‘veiled threats of litigation’. It quotes Section27 executive director, Mark Heywood, as claiming that a struggle was on behind the scenes between role-players who have ‘vested interests’ in the health sector.
Heywood is part of the ministerial advisory committee on the NHI. He said it was clear from the presentations of hospital groups on the Green Papers that their lawyers are ready for action to ‘litigate if the NHI is not the type of system they will be satisfied with’. Professor Louis Reynolds, of UCT’s medicine faculty, said during the debate nobody knows what is going on with the NHI. ‘The entire idea behind the development of healthcare systems is strong community involvement and transparency. Nobody currently knows what is happening behind closed doors. Why is the promised White Paper not being issued,’ he asked. Die Sake24 artikel spruit voort uit ’n debat oor die Nasionale Gesondheidsversekering (NGV) voorstel wat deur die South African Civil Society Information Service (Sacsis) en die Friedrich Ebert-stigting aangebied is. Professor Reynolds is bekommerd oor die gebrek aan deursigtigheid: “Die gevaar van agter geslote deure iets doen, is dat mense bespiegel. Ek dink daar is ’n geveg aan die gang tussen mense met gevestigde belange wat uit die ongelyke stelsel voordeel trek.” Volgens hom sluit dit ook in ’n stryd tussen die departement van gesondheid en die nasionale tesourie oor hoe die NGV gefinansier moet word, en of mense bybetalings moet doen om toegang tot dienste te kry. Hoewel daar nie voorgestel is dat daar van private gesondheidsorg of mediese fondse ontslae geraak moet word nie, sal ’n behoorlike stelsel hulle oorbodig maak – en dís hoe die private sektor dit beskou, het hy gesê. Melanie da Costa, direkteur van strategie en gesondheidsbeleid van Netcare, het in reaksie gesê die hospitaalgroep ondersteun hervormings ten volle om “toegang tot goeie-gehalte-gesondheidsorg te verbeter”. Heywood het gesê die ondersoek na die gesondheidsektor wat die Mededingingskommissie beoog, word reeds aangeval. “Die markondersoek is egter belangrik sodat maniere gevind kan word om pryse te verlaag en die druk op die openbare sektor te verminder. Maar daar is sekere instellings wat nie eens wil hê dat die ondersoek verby die verwysingsterme-fase vorder nie.” This is not the only instance in South Africa where long entrenched privileges are being defended – the current debate between the Judge President and the legal fraternity stems from the same basis. Perhaps the solution lies in one of Steven Covey’s seven habits. If the differing parties begin with the end in mind, they may find that give and take is a fifty/fifty transaction – not one where I take 50% and you give 50%. This will never produce a win/win outcome.
