Cyril Ramaphosa: Health care system unjust, NHI will bridge the gap

President Cyril Ramaphosa on Monday said the country's health care system, in which those who can afford medical aid are better off while the majority depend on public health care, was "unjust and unfair".

Ramaphosa said the National Health Insurance (NHI) was the much-needed intervention to put everyone on the same pedestal of quality health care, which is a constitutional right for all.

He wrote in his weekly newsletter that it was unsustainable that 20% of the country's population who are on medical aid have R250bn worth of medical care cover per year while the remainder of the population, who are dependent on public health care, are covered by R220bn through public funds.

"This flies in the face of the constitutional right of access to health care for all citizens, regardless of their socioeconomic circumstances. It is a situation that cannot continue. It is inefficient and unsustainable. It is unfair and unjust," said Ramaphosa.

"The introduction of NHI will be among the most far-reaching acts of social transformation this country has experienced since 1994.

"We have enough resources in this country to enable every man, woman and child to receive appropriate, standardised quality health care." 

The NHI bill in parliament will soon be taken on a countrywide public hearings awareness programme towards its finalisation into law.

Ramaphosa said universal public health care was now a global phenomenon which South Africa cannot avoid.

He said: "This goal has become a major aim for health reform in many countries and a priority objective of the World Health Organisation (WHO).

"It is instructive that WHO defines universal health coverage as a system that should ensure that all people have access to needed health services (including prevention, promotion, treatment, rehabilitation and palliation) of sufficient quality while ensuring  the use of these services does not expose the user to financial hardship."

The president believes segregation in access to quality health care cannot be allowed to continue.

This "segregation", said Ramaphosa, brings back "bitter memories" of apartheid and colonialism, when access to quality health care was based on one's skin colour and "colonial settler status".

The high costs of private health care also did not help the poor, who would never be able to afford it.

The president said those who were members of medical aid schemes were finding it difficult to cope with rising premiums.

"Out-of-pocket payments are on the increase, draining disposable incomes and making it even harder for many to make ends meet," said Ramaphosa. "As a nation, a large share of our national expenditure goes to health care, yet there is a fundamental mismatch between what we spend and the health outcomes of our citizens.

"Just as we demand quality standards of health care for ourselves and our families, we should do the same for others," the president said. "Just as we would not treat a relative or friend badly because they earn less than we do, we should care enough that they have equal access to treatment and care when they fall ill."