As Cyril Ramaphosa signed the Last-Minute Lunge For 50% Election Hail Mary Bill this week — that’s National Health Insurance to you and me — and compared its critics to whites fearing the end of apartheid, all sorts of questions raged. Except, that is, for the obvious one: does any South African adult believe that the ANC’s version NHI is actually going to happen?
Come to think of it, I have a second question: is apartheid really the analogy you want to go with here, Mr President?
I mean, do you really want to be talking about a system of deprivation and abuse inflicted on a country by a rogue government when you’re referring to the healthcare system your party has run for the past 30 years, with highlights that include promoting superstitious hokum that allowed 300,000 people with HIV/Aids to die, your party re-electing to office the ANC official who let 144 Life Esidimeni patients die on her watch, and not being particularly fussed about Babita Deokaran getting murdered for exposing corruption in said health system?
I don’t need to tell you that the first of those two is a noble and excellent ideal, something this country should continue to strive for, while the second is a plan to open the last un-collapsed artery of the South African taxpayer, stick a hose in, and then continue living la dolce vita.
I didn’t think so. Then again, a lot of the current rhetoric is simply stupid noise, deliberately intended to confuse the issues. The ANC has been especially good at blurring one vital distinction, namely, that there’s a world of difference between the principle of socialised healthcare in general and NHI as introduced and overseen by the ANC.
I don’t need to tell you that the first of those two is a noble and excellent ideal, something this country should continue to strive for, while the second is a plan to open the last un-collapsed artery of the South African taxpayer, stick a hose in, and then continue living la dolce vita.
Admittedly, I have heard one fairly solid argument for NHI, based on the fact that the perfect is the enemy of the good. If a corrupt ANC is the problem (this argument goes) and NHI should wait until the ANC is either out of power or has cleaned up its act, then entire generations of South Africans would sicken and die without ever getting the treatment they deserve.
This is fair, though it still doesn’t address why the state can’t first try to get basic public healthcare right before it goes after private healthcare.
The main problem with all this talk, however, is that it obscures the bigger reality here, namely, that the NHI has been rendered almost irrelevant — and has almost certainly been doomed — by the fact that the ANC’s time in power is drawing to a close.
According to almost every expert quoted by the press, NHI will take years to implement. I’ve read six or seven, but nothing less than five.
In other words, if those predictions are accurate, the legislation signed by Ramaphosa on Wednesday will not be implemented by the current government but rather by the government voted into office in 2029.
On current form that’s either going to be an ANC-EFF coalition, or an ANC-EFF-MKP coalition, or — and this is a very long shot — and ANC-DA-Moonshot Pact coalition.
Neither the EFF nor the DA support the NHI in its current form: both would almost certainly kill it in the cradle the moment they entered government; the EFF because it doesn’t fix the current crisis in public health, the DA because DA voters don’t want anyone touching private healthcare.
And if Jacob Zuma’s MKP is involved in government, well, it means the economy is hours away from its final death throes, which means there wouldn’t be any money for NHI even if the coalition wanted to implement it.
No, Wednesday’s grand signing was nothing but electioneering theatre; and SA continues to wait for high-quality socialised healthcare, knowing, as every half-awake adult does, that it will get it only when the economy can get off its bloodied knees and begin to carry it.
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