Trade union Solidarity believes the power of medical services in South Africa will be negatively impacted if government decides to centralise the healthcare system through the National Health Insurance (NHI) Bill.

Speaking at a Healthcare Crisis Summit organised by Solidarity, in Pretoria, on Tuesday, CEO Dirk Hermann stressed that a decentralised approach with proper government structures in place was needed to sustain the NHI.

“We know by looking at State-owned entities (SOEs) in crisis such as South African Airways, Denel and Eskom that government does not have the capacity to manage large SOEs.”

He noted that the NHI programme would be the largest SOE in government, and that implementation of the programme would cost R357-billion, the bulk of which would be carried by middle-class taxpayers.

“If government wants to finance the system using value-added tax (VAT), then it means that VAT must be doubled. We can’t afford for this to collapse because it will directly affect South Africa’s economy,” he said.

He further noted that the country currently had an effective private medical system that needed to be supported by proper legislation and regulation to function even better.

“The more we empower the private sector and the more access we give ordinary South Africans to that sector, the more government can focus on an effective public system,” he said.

Also speaking at the summit, chairperson Flip Buys said that, since being introduced in July, the proposed NHI Bill has evoked much concern among practitioners, economists and the general public about the future of healthcare in South Africa. 

He noted that State interference would lead to increased medical costs, poorer service and more ill people in South Africa.

He further stated that this would be caused by over-regulation, which increases costs; price determination which distorts the market for medication; chemists closing their doors and preventing a free market system; limitations on the development of more hospitals, which creates superficial deficits that, in turn, increase costs; and regulations which prevent the training of more doctors and specialists, resulting in more deficits and increased costs.

“It is, therefore, extremely important that we use this time to influence the policy,” he said.