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News from the medical schemes regulator, the Council for Medical Schemes (CMS), that it is pressing ahead with a draft consultative framework on compelling the consolidation of medical schemes, tells us that the proposed National Health Insurance (NHI) is still the favoured government policy. The NHI white paper broadly proposes running one gargantuan national fund, akin to a single state-run medical scheme, to provide a universal package of healthcare for all citizens, thus the consolidation of medical schemes is required. The regulator is now seeking the amalgamation of medical schemes that cover fewer than 6,000 families to create a larger risk pool and, ostensibly, lower healthcare costs. This strategy remains the cornerstone of government thinking – a bigger fund, supposedly, will have greater bargaining power and be more economical. However, the inconvenient truth of this strategy, steeped in centrist, Marxist thinking, is that a single, centralised state entity can deliver se...

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