The South African health conundrum, a capitalist taleDate Released: Tue, 24 October 2017 16:01 +0200
Pouring money into the healthcare system did not improve services and South Africa was a living proof of that view, Health minister, Dr Aaron Motsoaledi, said yesterday while addressing the seventh Alfred Bitini Xuma Memorial Lecture.
Dr Motsoaledi said the international benchmark for health expenditure determined by the World Health Organisation was at 5% of a country’s Gross Domestic Product (GDP). South Africa spent 8.5% of its GDP on health.
“An average country in Europe spends 9% of its GDP. Russia, China and India spend an average of 4.5%. However, our systems are incomparable because they have better health outcomes than us. This is because we are capitalists,” said Dr Motsoaledi.
He lamented the lack of an outcomes based approach by the government. Holding no punches, he detailed how and why the country’s health system was failing on all fronts and the desperate need for the implementation of the much discussed National Health Insurance.
“The life expectancy and infant/maternal mortality are the two biggest indicators of developed and functional healthcare systems. We have no guarantees for anyone’s longevity owing to poor health services and greed,” he stated.
The South African Constitution stated that every citizen had the right to obtain healthcare. “The National Health Insurance (NHI) is a financing system that seeks to ensure that all citizens of South Africa (and legal long-term residents) are provided with essential healthcare, regardless of their employment status and ability to make a direct monetary contribution to the NHI Fund.”
He argued that the United States, supposedly a capitalist society, spent at least 18% of its GDP on health, making South Africa the second biggest spender. Where are we failing? he asked.
“Out of this 8.5%, 4% goes to only 16% of the population; to people such as me, most government officials and Members of Parliament, most of the university management present here through medical aid. In addition, because people follow money, every available expertise, skill, and professional administration of healthcare is concentrated in the medical aid sphere.”
The NHI aimed to fundamentally transform the manner in which South African health care was delivered “because health is the responsibility of the state towards developing its citizens.”
“This insurance plan is met with a lot of resistance in parliament because people fear that it will affect their medical aids. Currently government spends up to R20 billion on medical aid to ensure that a minority has the best healthcare,” he said.
“It is a no brainer. When you improve the healthcare system of the country, you improve its economic health and ensure its growth, much like a proper education system. We need to change the mind set of leaders before the whole system caves in like it did in Sierra Leonne,” he urged.
In 2014, Sierra Leone’s economy was growing impressively at 14% and it took just eleven months to collapse after the ebola outbreak. Projections said that it would take at least 20 years to go back to the growth they were experiencing.
Therefore, NHI is necessary for the security of our country, there is no risk involved in making healthcare available to all citizens.
“If you can ensure that citizens are healthy, have a longer life expectancy then the economy thrives and becomes reliable,” he concluded.
AB Xuma, born eNgcobo in the Eastern Cape is a former African National Congress President, a teacher and medical doctor who stood for human and social justice.
The Institute of Social and Economic Research (ISER) hosted the Memorial Lecture.