Chris Hani Baragwanath Hospital. Picture: BUSINESS DAY
Chris Hani Baragwanath Hospital. Picture: BUSINESS DAY

Trade union Solidarity has criticised the recent decision by the government’s biggest medical scheme to guarantee private hospital care to all its members, saying it was an admission of the state’s failure to run an effective public healthcare system.

Last week the Government Employees Medical Scheme (GEMS ) announced that even its lowest-paid members would from January 2020 have cover for private hospital admissions, as part of its efforts to standardise the benefits across its different options. Gems members constitute the majority of SA’s 1.1-million public servants, and currently runs to 720,00 principal members and their dependants.

Until 2018, Gems members on the lowest salary bands received all hospital care except admissions for childbirth at state hospitals.  That began to change this year, when Gems extended their private hospital cover a limited range of admissions, which will be further expanded next year.

Solidarity welcomed the move to provide better cover for public servants, but said the development smacked of hypocrisy. “While Solidarity welcomes the decision itself and believes that all South Africans should have access to private medical care, (it) sheds light on the state’s incoherent behaviour which, on the one hand, regards National Health Insurance (NHI) as a highly necessary intervention, but then negotiates access to private services for their own officials,” it said in a statement.

Solidarity is campaigning against NHI, the government’s policy for achieving universal health coverage, which it regards as an attempt by the government to nationalise private healthcare. Expanding the state’s involvement in healthcare to the point where it managed both the public and private sector would see the entire system fail, it said.

The first piece of enabling legislation for the policy, the NHI Bill, is before parliament, and proposes establishing a central fund that will purchase services from accredited public and private sector providers. Its provisions for medical schemes, which are used by 8.9-million people to pre-fund access to private healthcare, are unclear and raise questions about whether people will be able to opt out of using state healthcare services once NHI is fully implemented.

“It is ridiculous that the state wants to place the lives and health of all South African citizens subject to a system they do not even trust with their own health. The message is clear: It will be public healthcare for you, but private healthcare for those working in the state,” said Morné Malan, senior researcher at the Solidarity Research Institute.

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