South Africa: NHI Mustn't Just Be About the Money - Let's Not Forget Human Rights

opinion

The NHI debate cannot be dominated by 'financing of health' language: the absence of human rights principles and safeguards can easily translate into sectors of our population being left behind in healthcare.

The long-awaited and thorough Health Market Inquiry (HMI) report paints an alarming picture of private healthcare. The report indicates that private healthcare in South Africa is characterised by high and rising costs, significant over-utilisation, no documented measures for health outcomes, highly concentrated facilities and administrators, and medical schemes that are not sufficiently accountable to members.

The performance of public health is also beset with numerous challenges and the 2018 Auditor-General's report indicates that more than 50% of health facilities are near collapse and require immediate intervention. Drivers of system dysfunctionality include poor capacity and resource constraints, shortages of health facilities and human resources practitioners and specialists, governance issues and corruption, and runaway medical-legal costs.

These prolonged and systemic failures in our health systems are affecting equitable access to healthcare, with infringements on our right to health. It also means that the pathway towards an integrated and functional health system is a challenge of enormous magnitude.

While the HMI report makes some far-reaching recommendations to rectify regulatory failings in...

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