There is no question that health is a human right. A healthier nation is a more harmonious, productive and prosperous one. So it’s hard to find fault with the government’s aspiration to end SA’s deeply inequitable health system, which sees the well-off paying for high-quality private healthcare while the poor are left to take their chances with the state’s patchy offerings. Last week Health Minister Aaron Motsoaledi unveiled the first piece of enabling legislation for the government’s policy for achieving universal healthcare. The National Health Insurance Bill proposes establishing a central fund, financed with mandatory contributions from those who can afford to pay: the fund will purchase services on behalf of the population from accredited public and private sector providers. This is a far more complex system than the existing one, which the government has failed to fix. And the trouble is South Africans have lost faith in a public service that has forgotten how to serve.

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