The unemployment rate in South Africa, according to statistics is set to be in the region of 33% in February, 2024. The original plan for the funding of universal healthcare coverage was to use the National Health Insurance Fund (NHI) which is tax deducted from salaries of workers plus taxation of companies.
The UK, which introduced NHS, their universal healthcare coverage system in 1948, has always had the lowest unemployment rate over the years, which currently stands at 4,2%. That is the first important difference between the two countries.
The second significant difference is that even with their very high employment rate, as a highly industrialised country, their universal healthcare coverage has throughout the years been supported by the expatriates they recruit from all corners of the world.
In 1998 when I applied for a job in the UK, the letter I received on the working conditions was that 25% of my salary would be deducted for pay-as-you-earn tax and 9% would be deducted for health insurance, and I thought 34% total deductions from my monthly salary was not worth the trouble, instead I accepted a job offer from the Middle East which had very attractive working conditions.
So their health system in the UK gets financial support, and the advantage of labour recruited from other countries, because they have the money to do so, which South Africa does not have.
They have strong visa and immigration controls, we have porous borders, with an unprecedented influx of immigrants from all corners of the world, which have strangled our financial and human resources since the dawn of democracy, with neighbouring countries like Zimbabwe, Mozambique and others exploiting our meagre health resources.
We have an unbelievably high medical negligence claims bill that runs into billions, something unheard of in other countries.
We run out of food and medication for acute and chronic patients in those hospitalised and primary health care centres.
We have a chronic shortage of all categories of health professionals.
We have a high attrition rate with many nurses reaching retirement age, with very few recruits undergoing training for nursing.
These problems do not seem to matter or make any sense to the ANC government and ANC members; to them the proof of the pudding is in the eating. Very few countries can successfully implement and sustain universal healthcare coverage, it is challenging and very demanding.
Two examples have shown beyond any doubt that not every Tom Dick and Harry can successfully implement UHC. Zimbabwe collapsed its health for all version of UHC that was introduced by late president Robert Mugabe in 1992.
Cuba, with its long history of UHC, is struggling to sustain it, depending on its diaspora working in other countries for assistance, to provide medication and many other essential supplies.
So, if the government is adamantly looking for trouble, it can go ahead and push the country over the cliff, but it is very unfair that the incoming government next month, will have to pick up the pieces, as the ANC government has delayed the implementation of this unworkable policy long enough for someone else to deal with the mess, while its own wishes will have been accomplished, because it will have received the votes of the ill-informed poor and destitute communities who are always hoping for free services from the government, even though they have been let down so many times in the past.
Cometh Dube-Makholwa,
Midrand