Response to COSATU’s Health Care expectations for the State of the Nation Address 2012

The Helen Suzman Foundation (HSF) expresses its concern at the recently expressed expectations by COSATU made in anticipation of the State of the Nation Address on the proposed National Health Insurance Scheme. The HSF agrees with COSATU’s recognition of the poor quality of care in the public health system, but believes that it is premature to demand the implementation of the National Health Insurance scheme as it stands in the Green Paper released in August last year.

Firstly, COSATU’s support for the implementation of the National Health Insurance (NHI) is problematic when NHInsurance is not properly defined in the NHI Green Paper.  ‘National Health Insurance’ has been branded as a cure-all for the health care system despite that fact that the citizens of South Africa have not been provided with other viable alternatives to health reform. Debate has thus become truncated.

Second, the HSF’s analysis of the NHI Green Paper found that it does not accurately diagnose the real causes of South Africa’s health care problems. In fact, it consists mainly of claims and assertions which are not backed up by evidence-based research. It is thus difficult to understand how COSATU can have faith in a policy so thinly based on evidence.

Third, there are too many areas in the National Health Insurance Green Paper that lack detail such as the fiscal, constitutional and legal implications of such a policy. It is difficult to see how the NHI could be implemented without addressing these important details.

In conclusion, COSATU’s claims that the NHI is the only way to fix South Africa’s ailing health care system are thus concerning. The HSF acknowledges that appropriate health reform is required. However, if that health reform is to come in the form of National Health Insurance, the Department of Health needs to engage more collaboratively with stakeholders and the broader public, and provide solutions to South Africa’s poor health outcomes which are strongly based on evidence.

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HSF’s health care expectations for SONA 2012
The Helen Suzman Foundation voices its concern as to how the NHI proposal will be accommodated in the State of the Nation Address. Outright support for the NHI and its proposed implementation for later this year would be deeply disappointing, given that Government has yet to formally respond to the submissions made by civil society and other stakeholders on the Green Paper. Having reviewed civil society’s numerous responses to the Green Paper, the HSF is convinced that major amendments to the policy proposal are needed, if not an entirely new proposal put forward if South Africa is seriously to begin reforming its health system.

8 February 2012