While debates rage about the National Health Insurance (NHI) Bill in South Africa and its shortcomings, Wits School of Governance professor of public governance Robbie van Niekerk says it is “a big idea” everyone should be discussing.
He says this is perhaps the most significant social policy introduced since the advent of democracy as it deals directly with the inequality of resource distribution between social classes. Health provision is a public good that affects all inhabitants of SA.
“I don’t think we have reached the point of a societal foundation because we failed to effectively communicate to the mass of society the scale of the inequality and the long-term benefits of a universal public health system as originally envisaged by the NHI,” says Van Niekerk. “That is a troubling element in how this debate is unfolding. It’s a wake-up call.”
In SA, 50% of yearly health spending — public and private combined — is incurred by the 16% of the population covered by medical aid and the other 50% on the 84% of the population wholly reliant on public health or those who make small payments for private health care.
Van Niekerk says: “Is it any wonder that our service delivery system is...