South Africa: Ambitious National Health Insurance Plan Stalked By the Shadow of State Capture

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National health insurance is a fabulous idea for the nation and for social justice. But with the history of State Capture and a notoriously inefficient state, there is a risk of putting health at risk.

Any democratic South African with a smidgen of care for social justice can only support the philosophy and ideas behind the National Health Insurance Bill released last week. It seeks to create a single national health fund by pooling the state's health budget of R222.6-billion with what is spent on private medical aid R162-billion to cross-subsidise and create a better public health system.

Yet, the ideas in the draft law have been met an uproar by the medical aid industry, by organised doctors and individuals. At issue is two things: the first is that the bill is written as if the era of State Capture, in which R1.4-trillion (and perhaps even more) was stolen from the public purse by various patronage networks, did not happen. The bill recreates structures and systems that suggest it will encourage exactly the same systems of State Capture. The second reason is that the bill is written in a bureaucratic vacuum, as if its drafters assume a perfectly efficient public...

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