“Health goes beyond public hospitals and access to doctors and should be of common concern to all,” he says.

He was speaking at a Leader’s Angle event about the National Health Insurance (NHI) Bill hosted by USB earlier this month at the FNB Portside Building in the Cape Town CBD.

“South Africa’s current health system is not designed for the poor.”
– Minister Motsoaledi

Motsoaledi admits there are problems in the healthcare system, but that mismanagement and corruption are secondary to the primary problem of inequality in the health system. “There is corruption in the health care, as there is elsewhere in the country,” he says.

He says South Africa spends a total of 8,7% of GDP on health while the World Health Organisation recommends that countries spend 5% on this. “The private sector spends 4,5% of GDP on health but only provides care to 16% of the population while the public sector spends 4,2% of GDP on health to care for 84% of the population,” he says. “This is gross inequality.”

Motsoaledi says universal healthcare access is part of the United Nations (UN) and World Health Organisation’s sustainable development goals, but South Africa’s current health system is “not designed for the poor”.

“They can move the budget to 20% or 30% of GDP but it is not going to change anything as long as we don’t change the fundamentals of healthcare financing. In terms of expenditure we are in the same group as Europe (9%) but our healthcare system compared to theirs is from two different planets,” he says.

He added that the outcomes of the Healthcare Market Inquiry (released in July this year) reports that that people are associating quality healthcare with exorbitant pricing. “That is unrealistic,” he says.

Watch the video here:

https://www.usb.ac.za/wp-content/uploads/2018/11/NHI-Leaders-Angle-Video.jpg

Also speaking was Prof Ronelle Burger, economist and researcher in the Faculty of Economic and Management Sciences at Stellenbosch University, who says according to household surveys, 17,5% South Africans have health insurance. “If you get a job your likelihood of having health insurance increases to 50%. But it is especially those with well-paid jobs that are most likely to have health insurance – 81%.”

She says the number one reason for people not having health insurance is because they can’t afford it. “Nine out of ten people who don’t have health insurance says it is because it is too expensive and not because they don’t want to spend money on it or because they are seldom ill.”

Dr Boshoff Steenekamp, senior strategy advisor at MMI Health who also spoke at the event, agrees that there is massive inequality in our healthcare system.  “Countries spending around 1000$ a year per person (for health) have life expectancies of about 70 years old. South Africans spending the same amount have a life expectancy of 56 years old.

“We are spending a lot of money, we are spending it unequally, and we are getting very poor outcomes. Nobody is going to fund voluntarily someone else’s sick old grandmother. There has to be compulsion and that is the role of the state,” he says.