CYRIL Ramaphosa and the other lead singers in the ANC's National Health Insurance (NHI) choir know they will never find themselves in state hospitals like Cecilia Makiwane, Charlotte Maxeke, Pelonomi or Dora Nginza, waiting to be treated.
They will either be dead by the time the scheme is fully implemented or they will ensure it is amended so that there is still an option for private care.
Or, like Jacob Zuma and David Mabuza, they will fly to Moscow (or London — or Nairobi?)
Can you imagine billionaire Ramaphosa or multi-millionaire Paul Mashatile in tattered hospital gowns waiting for a doctor in the corridors of Frere or Boitumelo hospitals? Not going to happen.
Ramaphosa's signing of the act, on national television and with political drum majorettes, was an act of blatant opportunism and politicking exactly two weeks before the general election.
If the act will only be fully operational in a few years or a decade, what is the harm?
Well, it creates dangerous expectations and destabilises the entire healthcare sector.
Recent surveys among doctors, anaesthetists, radiologists and other specialists indicate that more than 40% of them are seriously considering emigrating if the NHI is implemented. This process may begin now anyway.
There were reports yesterday of people with serious medical conditions planning to show up at their nearest private hospital and insist on surgery, and members of medical funds considering ceasing payment.
As the law stands, the entire healthcare system will be centralised and managed by the state. Medical funds will then only cover extraordinary procedures like plastic surgery.
Such a centralised fund is a massive, complex thing that throws all 60 million South Africans into one pot. In much more developed and sophisticated Britain with just 6 million more people, the National Health Service struggles. Emergencies are handled quickly, but for other surgeries and treatments patients have to wait months, sometimes more than a year.
Everyone commenting on the NHI first says they believe all South Africans are entitled to significantly better healthcare and that the gap between the treatment insured and uninsured receive should be narrowed or eliminated. Of course, this is true.
But if the motivation for the NHI is taken to its full conclusion, there is surely also a case to be made that the private security industry should be nationalised and incorporated into the South African Police Service?
Are all South Africans not equally entitled to personal security and the protection of their property? Why should only the wealthy enjoy the luxuries of night guards, alarm systems, bodyguards and street patrols when the poor usually live in the most dangerous environments?
After all, the “right to life" is enshrined in Article 11 of our constitution.
Should we then start talking about abolishing first-class and business-class airline tickets, first-class carriages on trains and luxury airport lounges?
Should we nationalise health insurance for pets too? Should we ban private schools, colleges and universities so that everyone receives the same treatment?
We read almost every week about widespread corruption and the appalling conditions in certain state hospitals.
The student aid fund, NSFAS, is in disarray and riddled with corruption.
The state struggles to make the relatively simple system of social grants work smoothly.
The multibillion-rand Road Accident Fund is a crime scene.
The state has run state-owned enterprises like Prasa, Denel and the Post Office into the ground over the past few years.
And now we are going to entrust the same people with a behemoth that will cost more than R500 billion a year — and with our own health?
Can people be blamed if they suspect the new scheme is just another chance for the cadres and their friends to steal billions?
The two-tier system works excellently in the Western Cape. Besides the excellent private hospitals, there are places of internationally acclaimed excellence like Groote Schuur and Red Cross Children's hospitals. State hospitals in smaller centres like Worcester, George and Riversdale provide exceptional healthcare services.
The people of the Western Cape who do not have medical funds may receive lower-quality linens on their beds and less tasty food than patients at Mediclinic, Life and Netcare hospitals, but they are treated properly and receive the same professional medical care.
If the Western Cape can get it right, why not the other provinces?
And if all state hospitals provide proper healthcare, then we can just leave the rich and the middle class who prefer to pay big money every month to be pampered in luxury hospitals. After all, it's their own money, and besides, it takes pressure off the state's healthcare system.
Even if the new NHI system is rolled out soon, it is still urgent that existing state hospitals and clinics are drastically improved. There are many more of them than private hospitals and they will remain the backbone of any centralised system.
I do not detect the same urgency to do this as I see with the pushing through of the new act.
My biggest disappointment was when Ramaphosa, otherwise a voice of reason and moderation, blamed white people and the rich as the only ones opposing the NHI.
He omitted to mention that medical associations and groups across the spectrum and representing more than 25,000 doctors are also against the act.
If ordinary people begin to realise that the NHI is a disaster, the ANC will surely again blame whites and the rich for it.
A doctor friend of mine who mostly works in the townships commented: “Here comes a monumental fuckup that will make Eskom look like a small mistake. An inverter or a solar panel won't help you when you're seriously ill."
Health-shedding?
♦ VWB ♦
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Max du Preez is the editor-in-chief of Vrye Weekblad. He was the founding editor of the original Vrye Weekblad.
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