The proposed Medical Schemes Amendment Bill and the National Health Insurance Bill tabled by the ANC bring up four issues that will play a very important role in the health of the South African population:
- The Minister of Health will take charge of regulating and controlling all aspects of healthcare in South Africa.
- The control of the entire healthcare system will be nationalised to the State.
- The decision-making pertaining to healthcare will no longer be with the healthcare practitioner and the patient.
- The effective employment of healthcare professionals by the State will be brought about by licensing, accreditation, contracting and point of service delivery requirements set by the Minister of Health.
The ANC and Equality
The main problem with healthcare in South Africa is also the problem with South African society – a world-wide phenomenon called INEQUALITY.
Health inequalities within countries are associated with a variety of factors, several of which are encountered across all countries. Examples include sex, age, economic status, education and place of residence. Other factors may be more specific to a regional or country situation, such as migrant status, race, ethnic grouping, class, religion or other characteristics that can differentiate minority groups.1 We must face the fact that there are differences amongst individuals that are not remediable with current knowledge 2, for instance that a person’s sex is a determinant for pregnancy or prostate cancer.
South Africa has been described as one of the most unequal societies in the world. It has been said that crime in South Africa will not dissipate until there is a more equal society. Land redistribution (expropriation without compensation) in South Africa is seen as the only way to bring about equality. The Minister of Health himself has said that National Health Insurance (NHI) is the “land issue of healthcare”.
One is, however, reminded of the classic novel by George Orwell entitled Animal Farm, in which it appears at some stage during the struggle that “some animals were more equal than others”. This holds true in the South African context, where state-owned entities are set up for some comrades to capture to make them more equal than other comrades with the greatest NEED.
In population surveys, equal use of services across communities signifies inequity, because different communities have different needs. Therefore, what is generally considered as equity (equal use across communities) is in fact INEQUITY.2
Inequity is the presence of systemic and potentially remediable differences among communities that are defined socially, economically and/or geographically. Insights gained from experiences throughout the world indicate that solutions addressing the availability, accessibility, delivery and standard of healthcare must be specific, based on sound evidence and sensitive to local contexts.
What the ANC wants
The ruling party of South Africa is focused solely on what they want, and this is the exact opposite of what is NEEDED:
- They want to centralise the responsibility for regulating and controlling all aspects of healthcare into a single politically appointed politician, namely the Minister of Health.
- They want to transfer control from the private healthcare system to a state-owned entity and force the population groups that currently use private healthcare to equal use of services in the public sector, socially engineering a single, uniform population without special or unique needs or means.
- They want to take the decision making away from communities regarding their needs and means, to make decisions on behalf of society according to their political ideology of state control (communism).
- They want to capture and own the scarce resources in the healthcare space and, most importantly, the healthcare professionals responsible for the delivery of healthcare services to communities.
What people must do
We must fight for our universal right to make decisions regarding OUR OWN HEALTH, and to be recognised and acknowledged as separate individuals that must be treated equitably according to our needs and means.3
PEOPLE ARE NOT ALL EQUAL, BUT EVERYBODY MUST BE TREATED EQUITABLY.
1 HANDBOOK ON HEALTH INEQUALITY MONITORING: WITH A SPECIAL FOCUS ON LOW- AND MIDDLE-INCOME COUNTRIES. GENEVA: WORLD HEALTH ORGANIZATION; 2013 (HTTP://APPS.WHO.INT/IRIS/BITSTREAM/10665/85345/1/9789241548632_ENG.PDF, ACCESSED 10 APRIL 2016).
2 THE HIDDEN INEQUITY IN HEALTH CARE, BARBARA STARFIELD
3 WORLD HEALTH ORGANIZATION. WORLD HEALTH REPORT 2008: PRIMARY HEALTH CARE (NOW MORE THAN EVER). AVAILABLE AT: WWW.WHO.INT/WHR/2008/EN/