The goals behind national health insurance may be very noble, and no one wants to deprive any citizen of quality health care, but this bill has many detrimental consequences which will destroy South Africa’s health care. This is according to the opinion of Dr Ronel Goosen.*
Dr Goosen, who has been practising as a general practitioner for 26 years and who is currently working at a hospital in Rustenburg, recently expressed her concerns about the possible implementation of National Health Insurance (NHI) in an exclusive interview with Solidarity. She described the NHI as a national health care disaster waiting to happen. “The notion that rich people have to subsidise poor people is not feasible. Exorbitant tax contributions would paralyse taxpayers, and as a result, medical schemes will become unaffordable and will ultimately disappear,” Dr Goosen said.
If implemented, the NHI will leave South Africa’s healthcare completely in the hands of government and, according to Dr Goosen that is where the problem lies. “I have worked as a general practitioner in the employ of the state for nine years, and I can state with certainty that government does not even have the facilities to provide quality care to all of those who are currently in state hospitals, let alone providing a service to the entire South Africa.”
Dr Goosen is of the opinion that even in Great Britain universal healthcare is facing huge challenges. “Patients die while waiting for surgery. For example, patients can wait up to three years for hip replacement surgery. It is worrying to think that a developing country such as South Africa could even contemplate implementing such a system, while developed countries fail to implement it with success,” Dr Goosen rightly pointed out.
At this stage, only the idealist NHI dream is being presented to the public, while the sad reality is being kept from doctors and the public alike. Coming from the medical field, Dr Goosen contends that doctors did not think government would carry on with NHI, and dismissed rumours as empty election promises because they did not receive any written notice about its scope and implementation.
According to Dr Goosen, the absence of a comprehensive strategy creates a sense of concern among doctors. “For example, common questions such as where all the patients will be hospitalised, how the gap between private and public health care will be bridged, as well as questions about how everything would be funded, remain unanswered,” Dr Goosen said.
In reply to the question of what impact she believes NHI would have on healthcare in South Africa, Dr Goosen stated unequivocally that should government carry it through in its current form it would result in a huge exodus of doctors from South Africa. “No matter how we look at it, South Africa does not have the background or a framework in place for NHI. The meagre healthcare service which government currently provides speaks volumes. Public health care will collapse totally and people will pay for it with their lives,” Dr Goosen warned.
*Dr Ronel Goosen is a pseudonym.