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Motsoaledi says NHI not about votes – but rather solving inequality

Health Minister Aaron Motsoaledi told a University of Stellenbosch Business School event in Cape Town on Thursday that government isn’t trying to chase votes with the National Health Insurance (NHI) according to Fin24.

Motsoaledi said that 90% of South Africa’s current healthcare system is designed for ‘well-to-do’ people and not the poor, but health needs don’t change with socio-economic class.

If you get cancer – the best treatment is the same whether you’re rich or poor, the difference right now comes in whether you can pay for it.

Right now, according to Motsoaledi, South Africa spends about 8.7% of its GDP on healthcare.

Government is spending about 4.2% of GDP to cover about 84% of the population, with the rest being private sector spending which benefits about 16% of the population.

My Take

There is nothing to be ashamed of, as a ruling party, when it comes to making decisions that are good for the public because they win you votes.

That’s how democracy is supposed to work – if you run things well, the people vote for you, if you run them badly the people are supposed to vote for somebody else.

In South Africa, historically, we as a public have not done that. We have allowed ourselves to be distracted from this by the racialisation of our politics, allowing state capture that benefits the precise same forces we’re getting so racialised over.

If we voted on performance – Cash Paymaster Services (CPS), wouldn’t have benefited for so long from an irregular contract with the department of social services to distribute grants.

The tender for that contract for the tender that CPS won, was worded in such a way that it gave them a monopoly. Net1, which owns CPS, has an all white board.

They were literally white monopoly capital, and yet the defenders of corruption nowadays seem to think that’s what they’re fighting against.

Our problem isn’t the ANC doing things to win votes, that is what a political party is supposed to do, our problem is the ANC engaging in corrupt activities that harm the public and not particularly suffering the consequences for it, thus allowing our governance to deteriorate to the point where it has become a crisis.

My view on the NHI is that it is a good idea, but the argument presented here doesn’t fill me with confidence.

I think the NHI, if run properly and not simply as an additional revenue stream for the corrupt, would be an economic boon.

First there is the issue of public health. Sick workers, if they don’t show up to work aren’t productive. If they do show up to work, they’re anti-productive, they actually reduce production to less than if they’d just stayed home.

Universal healthcare reduces the cost in lost productivity that comes with illness.

Not only that but it actually reduces the burden on our healthcare system. People being able to go to a doctor for free, would mean we spot diseases before they get serious – and thus can spend less on treating them.

Further some diseases spread, so giving people healthcare means we get the benefits of herd immunity – the diseases don’t get the same chance to move through our population. Our sick workers’ unemployed friends and family get covered, and thus don’t spread their diseases to the employed.

Even in terms of economic stimulus – the money that is currently going towards medical aids and insurances can be spent on more productive stuff, it increases the liquidity of our consumers for just about every other industry.

What we need isn’t talk about inequality – the rich don’t benefit from the poor getting sick, they benefit from their workforce being able to work – we need assurances that the people in charge of running this program won’t be the same cadres who have robbed everything else.

The primary issue we have to deal with, the primary concern is not about economic class, the primary concern we’ve got to deal with is the massive corruption and incompetence we’ve seen in government.

Because much as a well run NHI would be a great help to us, if it isn’t run well we may as well not do it, because it ends up as just being another double tax. We have to have the NHI – and the same old medical aids we had before because the NHI is just a venue for looting.

Our problem isn’t with the promise, it is whether the government as it currently stands is even capable of delivering on it.

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