One of the most damaging aspects of our public discourse on National Health Insurance (NHI) is the mistaken notion in some quarters that the only two options are NHI and the status quo, argues Marcus Low.
Investment in public health facilities is crucial as the country weathers storms on various fronts – from drought (water shortages) and flooding putting strain on health infrastructure to a harsh economic climate that makes private healthcare unaffordable to more and more people. Mbali Baduza and Matshidiso Lencoasa assess the investments in infrastructure in the budget and what it means for the planned National Health Insurance system.
Budgets, while important, are not the right mechanism to drive the structural change needed to improve the responsiveness of our public health system in meeting the needs of the population. But, argues Russel Rensburg, we can reorient the health system towards meeting the health needs of the population and then let the budget bolster the reforms. Here he provides some suggestions on how to go about it and contrasts that with the budget announced by Minister of Finance Enoch Godongwana this week.
The Health Department’s recent response to submissions and its own recommendations on amendments to the National Health Insurance Bill sadly does not realise the gravity of the threat to the future of medicine selection and access. As the Bill currently stands, it will leave us at the mercy of advisory committees that bear no duty to be transparent in deciding which medicines people will be able to access under NHI, the authors argue.
South Africa is among the most unequal countries in the world with a huge quadruple burden of disease and to address this we need hands. Professor Parimalaranie Yogeswaran argues that we should maximise the untapped potential of clinical associates to beef up the clinical health workforce.
Framing the fundamental human right to healthcare as insurance cover opens it up for exploitation. It blocks any possibility of achieving equity in health care. Here Dr Louis Reynolds from the People’s Health Movement of South Africa explains why and how.