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Health minister Aaron Motsoaledi. Picture: DARREN STEWART/GALLO IMAGES
Health minister Aaron Motsoaledi. Picture: DARREN STEWART/GALLO IMAGES

Health minister Aaron Motsoaledi accuses those pursuing legal challenges to the National Health Insurance (NHI) Act of being motivated by selfish, elite interests (“Health minister flays Solidarity’s ‘elitist’ challenge to NHI”, November 29).

Yet China and Russia accommodate private alongside public healthcare. Both countries have been moving away from a purely state-operated health system, because they accept that recognising the needs of the middle and upper classes when it comes to health treatment is essential to facilitate business investment and economic growth.

Their approach could work in SA. Both countries also want to preserve a degree of equity between rich and poor, and allow private medical insurance funds to offer all medical procedures, including those provided by state hospitals. Both have mandatory employee/employer contributions to their state fund (whether or not the employee also has private cover).

China in particular attempts to preserve basic equity by controlling prices for private medical services. Both countries also require private hospitals to take quotas of state patients at state rates.

Both Russia and China encourage collaboration between private and state hospitals, and recognise the role of private hospitals as setting benchmarks for excellence for the benefit not only of their private patients but also as a route to enhancing the quality of care in state hospitals.

If Russia and China, both counties with Marxist foundations, have no problem accepting a parallel private-public health system, surely we can do the same? Sadly, it seems our health minister is trapped in the Russia and China of 50 years ago.

Willem Cronje
Cape Town

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