COSATUs NHI Proposals / Dangerous and Unworkable: DA
It follows Vavis address at the SA Medical Association?s conference a week ago during which he called for a radical shift in the way health care in SA is funded by incorporating all health care resources in the public sector.
According to Vavi, COSATU defines NHI as a state-mandated, state-administered system, in which a single authority organises health finance aimed at ensuring that all persons, irrespective of financial status, have free access to health care at the point of service.
Waters said the trade union?s proposals ignore overwhelming evidence from around the world that the most successful health systems are those in which there is substantial involvement in the delivery of services by the private sector.
Vavi?s opinions, if they were to be taken up in national policy, would put an end to the possibility of establishing a health system which could truly meet the health needs of all South Africans, Waters said.
COSATUs stance seems to contradict earlier assurances by the ANC that the private sector will have a role to play in a NHI. Both SAMA and private hospitals have given their support to a NHI, saying that it provides an opportunity to address the disparities in the country?s healthcare system. At its conference, SAMA officially endorsed the principle of universal access through a NHI but emphasised that both the public and private sectors have a role to play in achieving the objectives.
Speaking at the conference, the associations outgoing president, Prof Ralph Kirsch, made it clear that the time for talking about universal access to health care for all South Africans is over.
The debate should now be about how to deliver and fund the services needed to ensure that everyone, rich and poor, have access to the same quality health care providers would want for themselves and their families, Prof Kirsch said.
But according to Vavi, there will be no place for the private sector in a system as envisaged by COSATU. With 8.5% of GDP spent on health in 2006, SA has enough resources to provide health care to everyone. What is required is the redistribution of these resources, from the minority of the population to the majority, Vavi said.
He blamed, what he called the two-tier, contradictory, wasteful healthcare system? for most of the countrys healthcare challenges. On one hand is a public health service that treats health as a social need, yet is starved of adequate funding and resources. Less than 40% of total health care resources are in this sector, yet it serves 85% of the population, the majority of whom are black and poor. On the other is an expanding private sector, which treats private health care as a commodity, accounting for more than 60% of the total healthcare resources, including a majority of health professionals, yet it serves a minority of the population, the majority of whom are white, and wealthy, Vavi said.
He added that the private sector creates a market-driven private healthcare system based on avoiding the sick. Medical schemes and private providers compete not so much by increasing quality and lowering costs, as by avoiding unprofitable patients and shifting costs back to patients or to the under-funded, under-resourced public health system, he said.
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