With the proposed National Health Insurance Fund set to kick off in 2012, experts warn that there are factors that have been overlooked. The plan fails to deal with the actual problems in the current health care system and fails to suggest suitable solutions.

According to Alex Van Den Heever, a consultant for healthcare finance and social reform, the “NHI is not itself the fix that is required for our healthcare system; instead, those in charge of health care need to adopt good governance and to be accountable for the healthcare services on offer”

Van Den Heever’s point of contention is that there are endemic problems within the health and educational sectors which are not suitably addressed through increased spending, but rather through measures enforcing accountability.

In order to effectively combat the shortcomings of the current health care system, one has to understand the problems which confront it. The NHI document, does not deliver a single proposition to deal with the aspects of zero accountability and lack of governance in the service delivery of national healthcare.

The ANC is proposing increased governmental expenditure from 3.5% of GDP to 8% of GDP. The estimate for expenditure for 2012 is R128 Billion. According to Van Den Heever, South Africa compares favorably with countries where the population has a similar GNI. (Gross National Income).

“In 2005, the South African government spent about US$340 per person on health care, which was more than the average of about US$300 spent per person that year by the 15 countries with a GNI per person above that of South Africa and the 15 countries with a per capita GNI below that of South Africa. (The GNI was measured in United States dollars adjusted to reflect the purchasing power parity of each country.)” (Personal Finance, 27 Nov. 2010, NHI ‘won’t cure’ the ills that plague our healthcare system,www.persfin.co.za, accessed: 01/12/2010)

According to Van Den Heever, the effectiveness of a countries health care system can be measured by maternal mortality rates. South Africa’s maternal mortality rates do not compare favourably with the countries mentioned above in the comparison regarding average spend per person. Therefore it can be reasonably assumed that something is amiss.

South Africa’s maternal mortality rate was estimated in 2005 to be 650 mothers in 100 000 live births and 410 per 100 000 in 2008. Comparing the 30 countries mentioned above, the maternal mortality rate was less than 100.

There are similar problems in the educational sector regarding governance and accountability. “South Africa is spending way more than its peers on education but with poor results: poor children in South Africa fare far worse when it comes to the level of education they achieve compared with that of poor children in other countries.” (Personal Finance, 27 Nov. 2010, NHI ‘won’t cure’ the ills that plague our healthcare system,www.persfin.co.za, accessed: 01/12/2010)

It seems that there are certain inconvenient truths confronting our national government that are being overlooked and stifled by increased spending which is ultimately covered by the citizens of South Africa.

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