The Association of Civil Servants (USA), which represents more than 235,000 employees in the public service, is deeply concerned about the proposed national health insurance (NHI) and says that at this stage there are far more questions than answers about the proposed system.
“The US supports any effort to ensure universal access to health care and recognizes that access to health care is a fundamental human right enshrined in the Constitution.
“However, it is important to emphasize that it must be meaningful access with quality service, adequate medical supplies, clean and fully equipped facilities and sufficient staff with experience and expertise.
“Without these extremely important aspects in place, the NGV is doomed to fail.”
The USA also does not believe that a single health care system – such as the NHS – is the solution for access to meaningful health care.
“Over the years there has been a decline in the quality of public services in South Africa for various reasons, including the emigration of experts from the country, poor maintenance of infrastructure, lack of accountability, corruption, and the like.
“The question is whether the NGV will yield better benefits for civil servants and what the effect will be on their disposable income, since many of them already belong to medical funds.”
According to the USA, the idea that employees can be expected to pay for private medical care and the NPA at the same time causes anxiety and tension among these workers.
Furthermore, the rehabilitation of the sector must form the core of health reform in South Africa and this can only be achieved through a competent, impartial public health service that is free from corruption and political interference, says the association.
The US says that South Africa’s two-tier health care system is not the cause of problems in the sector.
“The demise of the private health care system through the introduction of a model such as the NGV and the imposition of taxes equivalent to the average medical aid spending will not produce efficient management and administration in the public health care sector either.
“The US calls for a progressive realization of the right to access health care within the resource constraints of the state. The proposed mechanism should aim to make healthcare accountable, affordable and efficient by strengthening what works in the public sector and removing shortcomings.
“It must be planned and implemented in a responsible, affordable and sustainable manner. The goal of achieving universal access to quality health care should not drive us to implement any and every program without considering its effectiveness.”
Instead, the US is calling for the full introduction of a human resources strategy to address skills shortages in the health sector.
“There must be a clear human resource plan to ensure training and staffing at facilities. There can be no reform of the public sector if shortages of skilled personnel persist. In addition, the graduate output needs to be improved on an urgent basis to meet the demands of the health sector.”
Furthermore, the USA is also concerned about the future of medical funds and how it will integrate with the NGV. This could in fact be the beginning of the end for medical funds.
“The introduction of the NPA could also undo the progress that has already been made in access to quality medical care.
“In addition to our commitment to support the rehabilitation of public health care, we also believe it is important that the public has the right to choose whether they want to use private or public health care – a choice that should not be placed on citizens through a tax burden does not become.”
