Sunday Times E-Edition

Q&A

DR NICHOLAS CRISP, deputy director-general of the National Health Insurance, told parliament this week that the country ‘needs to spend as much onhealth care as it decides to’. Chris Barron asked ...

How much will taxpayers be squeezed for?

In the short term, nothing, because it will be a long time before we start to shift the flows from the private sector.

How much will national health insurance (NHI) cost per annum? 8.5% of GDP.

Has it worked in any country with the same tiny tax base we have?

Lots of countries have been on these journeys. They take 15, 20, 25 years, but plenty have done it. If you look at Mexico, Thailand ...

Do they have unemployment rates approaching 50% like ours?

That’s this year. But what are we going to have in 15 years’ time? Do we believe we’re just going to continue to sustain this disaster?

Are you talking about our healthcare system?

No, I’m talking about the country that’s in a mess. It can’t stay in a mess forever. We have to pull it out of that mess, and we have to do whatever we need to do with our health reforms. If you want to strengthen the health system you must put more money in the health budget. It’s obvious.

We already have an extensive health budget, which has been terribly badly managed. Isn’t that the problem?

It is badly managed, and it does need to be improved. But I don’t know about extensive. It’s a small percentage of government spending, and we’d like to see more spent on health.

Instead of NHI shouldn’t we be focusing on effectively using the health budget we have?

It’s not an either/or. Sixty-seven percent of all the specialists in the country are in the private sector. How do we access those skills? They do amazing stuff but they’re not accessible to the people who get their services in the public sector. How do we access them if we don’t have a system that works more closely together and shares its resources more effectively?

Create a more conducive working environment for them in state hospitals?

How do we do that with the budget sitting at its current levels, with no more money?

Because it’s been mismanaged, wasted and stolen?

As a proportion of spending it’s not very different from the private sector, which reports R11bn a year stolen. We’re reporting ... well, it’s almost impossible to quantify.

How much is going to be in the NHI fund?

In 10, 15 years’ time the equivalent of around R400bn in today’s rand.

Can we trust a department mired in corruption not to abuse and steal it?

Obviously, that’s the hill we have to climb. Do we trust any government department at the moment? The answer is no.

Isn’t that why we can’t trust the government to run NHI?

This is 2022. I’m not planning for 2022. We’re planning for 2025, 2028, 2035. You have to start somewhere, you have to create a framework. If the NPA [National Prosecuting Authority] can do its bit, I can do my bit to design a system that will recognise and design out risk as far as possible. And when we identify the risk we work with the SIU [Special Investigating Unit] and police and everybody else to do something about it ...

Opinion

en-za

2022-04-03T07:00:00.0000000Z

2022-04-03T07:00:00.0000000Z

https://times-e-editions.pressreader.com/article/282059100517984

Arena Holdings PTY