NHIS: Are you serious?

Hoping to start my posts on AS with something a little more positive, I’ve been keeping an eye on the web and the papers for something suitable to dig my teeth into, but found that despite my search for heart-warming subject matter, that fine example of a well run governmental department, the Department of Health, was hell-bent on drawing my attention and ire away from such happy things. For those of you who have been hiding under a rock, here’s the gist of it: The Department of Health’s wants you to pay for public health. Oh wait, no, you already do that through your taxes, don’t you? Well they decided they wanted more of your paycheck so that everyone can afford private health care. Instead of pulling up their socks and putting the money they have to effective use first, they’re following the lead of all great leaders who are confronted with a problem they don’t know how to handle – they’re throwing money at it. In this case, your money. The ANC has proposed that the sum of R11 billion, which would be required to kick start this venture (never mind the maintenance), be drawn from the following sources:

-A surcharge on taxable income
-Payroll taxes for employees and/or employers
-An increase in value-added tax (VAT), dedicated to the NHI
-Removal of the tax credits that currently exist with regards to medical aids.

For those of you who need a breakdown, that means your disposable income gets a further chunk taken out of it via an income tax surcharge. South Africa already has tax rates comparable to a developed Western European nation coupled with some of the worst service delivery. How is this justifiable in any meaningful way? Secondly, payroll taxes… so they want to take an already over regulated business market where entrepreneurship is a frightening rather than an encouraged prospect and add extra payroll taxes? “Job creation? What’s that?”. Oh and while we’re at it, let’s pump up consumer prices with a VAT percentage increase, so that your recently amputated disposable income can buy even less. Absolutely. That’s bound to give the economy a good old kick in the nadgers. I could go on, but I’m hoping that by now you get the picture. This is about as well thought through as letting a 3 year old play on a flight of stairs.

I’m reminded of the biblical fable of the three servants entrusted with talents (currency) by their master and told to use it wisely in his absence. The three each receive differing amounts, but two of them invest their money wisely and earn interest on their initial sum.

This pleases their master and upon his return they are entrusted with further responsibilities in his household. The third buries the money so that he won’t lose it and maintains the single coin he was given without employing it to earn or produce anything. His master is highly displeased with him and casts him out.

In the same way, government departments who have consistently failed to implement functioning services with their given budget should not be rewarded with even more of our money to squander. If Health was not already receiving a relatively robust budget then their bleating about monetary woes being the downfall of the Department might hold some merit. Truthfully though, a department with a decent budget should not be collapsing the way this one is. I don’t think it’s unreasonable to expect that the bulk of systems should be working to at least SOME capacity. Sure those systems may need work and perhaps the occasional injection of new assets and funding where the human, equipment or infrastructural sections are particularly weak or buckling, but to have a failed implementation of public health with this kind of money being poured in just doesn’t leave much wiggle room for excuses and should certainly leave no room for a massive budget renegotiation such as the NHIS.

a completely unnecessary flow diagram

Health needs to get their house in order first, sort out their administrative ‘kinks’, get rid of the self-enriching layabouts that are bleeding the organisation dry and then once the paying public and those too impoverished to pay start seeing them delivering a decent level of health service to them, then ask for more money to improve on what you’ve done. Similarly, a bank wouldn’t give out massive loans to anyone who is a bad credit risk, and right now, the DoH is a bad risk. A bad risk that’s killing babies. There’s a long way to go yet before they get taken off the blacklist.