The South African health system has been imploding on its citizens for years now. The more obvious, needless, loss of life (HIV, infant and maternal mortality etc) in the public health services is now matched in the private sector by their own financial catastrophe. Medical schemes now assume extensive risk with no congruent obligation for the healthy to contribute during their well youth; their liquidity is limited by large, legislated reserves of idle money.
The responsibilities cut both ways: before even considering NHI, government needs to remedy crucial aspects of existing health legislation. Competition’s Commission (ie business) rulings have no place in health care –a sick person or their family will pay any price to avoid illness or death – and government has an obligation to regulate once again an ethically acceptable tariff. Similarly, legislation could make medical schemes immediately more affordable, and offload millions from public service dependence, by obliging every economically active individual to have medical aid cover. Congruent to government’s obliging provision of minimum benefits, and removing risk-rating, goes the responsibility to make this economically possible with a broad risk-base. The young and healthy need to start paying towards a healthy lifetime now.