LETTER: Access to private healthcare funds will not cure public sector ailments
NHI will grant extended power to future health ministers, including that of appointing people to the board of the NHI fund
The numerous crises that have beset the biggest hospital in the southern hemisphere, Chris Hani Baragwanath, do not inspire confidence in the aims of the proposed National Health Insurance (NHI) scheme (“Chris Hani Baragwanath Hospital ‘a disaster waiting to happen’,” July 3). Adding more layers of bureaucracy and introducing built-in incentives for cronyism, will not resolve the basic issues that plague Baragwanath and many other public healthcare facilities.
The NHI will monopolise the management of all healthcare in the hands of the state. In addition, it will grant extended power to future ministers of health, including that of appointing people to the board of the NHI fund. To concentrate that much power in the hands of one person indicates a fundamental lack of understanding of the causes, systems and incentives that allowed and encouraged state capture to take place.
Basic problems such as linen shortages and infrequent food supply will not be solved by placing Baragwanath and other facilities in the broader bureaucratised world the NHI will be. Shortages, miscommunication and a lack of accountability will only be amplified; these outcomes are guaranteed because of the system and the centralisation of power that it will bring.
Gaining access to private healthcare funds will not cure the ailments of the public sector — these funds will be wasted on inefficient and cronyist outcomes. Instead of attempting to expand its powers, government should focus on using current resources in a responsible manner, as well as bringing in private-sector expertise to get the basics right and upgrade facilities for those citizens who do not yet have access to private care.
Chris Hattingh
Centre for Risk Analysis
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