The recent cabinet adoption of the National Health Insurance (NHI) Bill has brought about a renewed enthusiasm for this massive project. Dr Anban Pillay of the department of health is its promoter and zealot. Even MDs in the medical insurance industry soft-pedal the obvious threats it poses to their business models. Maybe this is just their public face. Be careful what you wish for.

We are told by Pillay that medical aids and private insurance will be allowed to co-exist with state provision. Sounds okay. But what he does not say is that very few procedures (really only cosmetic ones) will be allowed under private care. The NHI, if implemented in its currently planned form, will decimate the private health insurance business.

Pillay is totally delusional about funding for his grand scheme. He passes this ball to the Treasury and glibly says that they will basically have to increase taxes. The middle classes must cough up. This is madness of a special kind.

The current model of state provision rationed by the queue and voluntary membership of private medical aids is good policy. It is the execution that can improve. If the government wants to cause mass trauma to and resultant emigration of the middle and aspirant middle classes, then it just has to proceed with NHI. And we all know that any sound democracy needs a growing middle class.  Destroy it at your peril. 

Anthony Still, Waverley