It takes healthcare as a basic human right and politicises it
Why did South Africans protest against the ‘dompas’ during Apartheid? It was not because they had a problem with identification documentation: every society in the world has some document by which people can identify themselves to each other, businesses, and the authorities. It was because the pass laws took away pre-existing freedom – the right to move around freely for work or pleasure – and required people to carry these permits to show that they are, in fact, authorised to do so. In other words, where people were once free, they suddenly had to navigate a complex and repressive system of State bureaucracy to enjoy but a vestige of the liberty they are inherently entitled to.
The NHI is no different. Whereas all South Africans currently have self-determination in matters of healthcare, the NHI will replace this freedom with a complex State-centred system of application, consideration, approval/rejection, and review. It takes healthcare as a basic human right and politicises it. But instead of targeting and disadvantaging one racial group as the dompas did, the NHI scheme robs everyone of their fundamental freedom of choice in healthcare. Worst of all, it douses the aspirations of the poor of one day having access to quality, private healthcare, and replaces it with the reality that we will all now have to share the same, shoddy public healthcare system that has already failed millions.
The way for the government to progressively realise the right to access healthcare is to provide funding for the private healthcare choices of the poor. This is a far better alternative to subsuming quality private care into the dilapidated, collapsing public health system.
South Africans should not allow themselves to be misled by the good intentions behind the NHI or the inspiring speeches delivered by health department officials. Nobody disagrees that affordable, quality healthcare is imperative in any society. The NHI, however, is a wrecking ball and will destroy South Africa’s continent-leading healthcare system. We have seen how the government failed to build a quality public healthcare system, and as a result, we should not allow it stewardship over the private healthcare system to which millions of indigent South Africans aspire.
About the author: Martin van Staden is Head: Legal Policy and -Research at the Free Market Foundation and is pursuing a Master of Laws degree at the University of Pretoria. He is author of The Constitution and the Rule of Law (2019).
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