The development of any country relies on the performance of its developmental indicators. Health being one of the indicators remains a central indicator to not only the country’s development but also the development of other indicators such as economy in the form of the GDP. The problem that developing worlds face is the access to health care. In South Africa, health care is regarded as one of the most essential public services. Health care contributes to the economy in the following ways, firstly it insures living expectancy, secondly it guarantees the wellbeing of the labour markets by ensuring that workers are healthy and productive, thirdly and lastly it keeps the economy in motion.
The question here is, does National Health Insurance make sense for South Africa? The answer to this question is found in the developmental goals set by the country however, this blog will articulate this from a different perspective which is the ability of public services to transform society with special focus on health care and the NHI in particular.
Previously in South Africa, health care was a minority privilege and this lead to many national groups being subject to illness and inadequate health care. This also meant that there was a disparity of infrastructure in health services between these national groups, thus leading to the prejudice and compromise of the other group. What the latter seeks to achieve is to lay out a genetic linage to the current health care system.
Post the democratic dispensation, the new government had a task to remedy the injustices of the past as the legal principle correctly puts it that, where there is a right, there is a remedy. The remedy to the context give in the previous paragraph was to give the groups that were marginalised the opportunity to have equal access to services such as health care and sanitation. What the government did was to codify these legal frameworks in the constitution of the country which also gave birth to a new legal jurisprudence.
The National Health Insurance comes at a time where the above codification has not yet been given effect by policy in the health spectrum. The NHI then provides an opportunity to give effect to the constitutional framework and align the spectrum with the National Development Plan. The policy of NHI provides a remedy to previous injustices which comes through capacitating the public sector which accounts for the majority of the population and also dispelling the myth that the public sector is only for the poor. Capacitating public sector in a country dominated by socio-economic inequalities is an immediate solution and probably a permanent one to the challenges faced in the health space.
The NHI makes sense in the context that it is a remedy rather than a structural overview of a problem. It diagnosis the actual problem and provides a solution. The solution might not be a scientifically accurate solution but it is viable to the status quo.