Cape Town - An economist said the ANC has not done enough homework on the "politically sexy" National Health Insurance (NHI) system it wants to implement. The plan was outlined in the party's online newsletter ANC Today on Friday.
Economist and dean of Research at the University of the Western Cape, Professor Renfrew Christie, said if actuarial scientists run the numbers and appropriate feasibility studies are carried out on the public and private health sectors, the conclusion would be that the NHI is not a feasible option for South Africa.
Firstly, Christie said, the scheme requires the cause of the problem - the inadequate state of the public health system - to be fixed.
SA also does not have the capacity to run what is essentially a R200bn public bank.
According to the ANC's proposal the NHI will simply be a financing system, with government collecting and allocating money for healthcare provided by either the private or public sector.
To ensure improved quality standards, all providers have to be accredited before the NHI funds them.
The system aims to allow anyone to attend a private or public hospital without having to pay. Public health funding and medical aid contributions would go into a pool from which the government would allocate money to doctors, clinics and hospitals.
Tax rebates for medical aid contributions would be abolished, workers who earn more than a set amount would have to make contributions to an NHI fund and there would be caps on what doctors or hospitals could claim for services rendered, the report stated.
Civil service not up to the job
"It's a rich country solution," said Christie. "Sweden has a tiny population, superb civil servants and was totally healthy when they did it.
"The UK had a superb civil service and buy-in across most classes in 1947 after the war; it was a richer country without pandemics," said Christie, adding the British National Health Service system took seven years to plot and plan.
He said this kind of scheme was a "huge" job for the best of civil services.
South Africa's civil service, Christie argues, does not have the technical expertise and capacity to run it.
Christie argued the best solution - given the state of public health services - would be to tax better earners more and spend the money on the public health system.
If the public health service were in adequate shape, the call to implement this type of system would probably not have come about in the first place, Christie said.
"If you want health, fix the health service you've got," said Christie.
In its outline, the ANC acknowledged the public health system has deteriorated over the past 15 years.
"In many areas, access has increased but quality has deteriorated," the outline read. "There are also many public hospitals which experience management failure related to the employment of incompetent managers.
Government is hoping to introduce a draft bill for the scheme by December. Health officials confirmed to Fin24.com that they expect the legislation to be passed in 2010.
- Fin24.com