The Congress of South African Trade Unions fully supports its affiliated union NEHAWU’’s campaign in support of the introduction of the National Health Insurance. We call on all our members and workers, in general, to join the union’s picket tomorrow the 18th October 2019 at the Netcare Head Offices in Sandton. The Federation is committed to not only the creation of the NHI but also the transformation of the health system, such as the poor state of the infrastructure, management failure, patients subjected to long queues, dirty laundry and shortage of doctors.
We need to deal with the unequal structure of the nation’s health system. It is characterised by stark inequalities based on race, class and gender. For example, data from the StatsSA General Household Survey (2018) reveals that only 16% of South Africans have access to medical aids. This membership is dominated by white citizens (72%) while only 10% of Africans have access to medical schemes.
Furthermore, South Africa’s health finance is very skewed when contrasted with other countries. An impressive 8.5% of GDP is spent on overall health services, but this is largely consumed by private health sector users and providers. How does a country justify a “two-tiered” health system in which half of the overall health expenditure is spent on 16 per cent of its population?
These figures also debunk the myth of limited resources within the system. South Africa’s health expenditure exceeds the World Health Organisations (WHO) recommended health expenditure of 5%. The NHI seeks to address this structural inequality within the system by providing an alternative Universal Health Coverage (UHC) model.
South Africans need NHI for accessing primary healthcare. Various health studies prove that South Africa’s health system is overly curative. This has significant implications for health service costs and the nation’s disease profile. A clear example is the continued rise of non-communicable or lifestyle diseases.
South Africa requires a preventative health paradigm and system, which is not over-dependent on curative health technologies and interventions. The NHI provides the building blocks for such a system through prioritising and institutionalising a primary healthcare model. It focuses on health service decentralisation through community healthcare workers, school health teams, and district health structures. These institutional arrangements are more suitable for achieving primary healthcare within communities.
The Competition Commission’s Private Health Market Inquiry found that three hospital groups (Netcare, LifeHealthcare and Mediclinic) account for 90% of the private hospital market. This concentration of power in the sector makes it vulnerable to collusion. Without much competition, the three major hospital groups dictate price increases for medical aids and benefit from the over-utilisation and over-treatment at private health facilities.
Section 39 of the NHI Bill curbs the private sector supplier-induced demand by setting requirements for service providers and facilities to comply with in order to fulfil NHI fund accreditation requirements. These include treatment protocols and guidelines, which cover medicine prescriptions, health product procurement, and health referral pathways.
Workers and communities need to rally around the NHI and defend it against those who want to continue with profiteering in the health sector. We reiterate our call for workers to support NEHAWU’s picket in Sandton tomorrow.
Issued by COSATU
Sizwe Pamla (Cosatu National Spokesperson)
Fax: 011 339 5080
Cell: 060 975 6794