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NHI Pie in The Sky

The following article was written by  Megan Harker Elliott after the event “Student Discussion on NHI” and it was published by the Africa Health News

National Health Insurance (NHI) seems pleasant to consider, but far away from realisation- “pie in the sky,” said one medical student saying, “when everyone is entitled to everything, no one is responsible for anything.”

Roughly 80 students showed up at the NHI student launch hosted by the Peoples Health Movement-South Africa (PHM-SA) which coincided with the eve of World Health Day at the University of Cape Town (UCT) to listen to speakers share their views and ask questions about the proposed NHI. While there were representatives from multiple organisations, student voices echoed independently in solidarity.

Quality Facilities and Service Delivery Needed

Addressing the poor service delivery in clinics and hospitals that still exist widely in the public health sector, Thandani Mlabo, as seen in the picture below, a fourth year medical student with a keen interest in the NHI said, “Our health slogan should be quality health for all instead of just health for all.”

Concerns About Costs

“How would 10% of the population carry the costs of the rest of population?” asked one student. Another felt if you taxed 500 000 people out of approximately 52 000 000 who pay tax, poor people would suffer the increase of consumer products and asked, “Where is money for the NHI going to come from? Another student pointed out that the same people that may pay the health tax also pay the fuel levy, value added tax, and many other taxes such as company tax.

The Brain Drain Continues

A student studying physiotherapy felt that a whole group of experts were not being engaged with, about the NHI, and were being lost in the process. The student said that some physio students considered leaving to countries such as Saudi Arabia for better opportunities without the concern that their medical sciences peers were left behind in South Africa with the burden of the public health system- “This is a problem,” said the student suggesting that all stakeholders take charge by engaging with the NHI.

Altruism vs Incentive

One student felt that the NHI is an idealistic idea for a society where everyone was optimistic and everyone was working toward the idea. The reality for medical students are considering what incentive there was for them to work for the state or to stay in South Africa. This student said, “I’m not very altruistic but I’m also not saying I want to perpetuate the system of those who get more, earn more, produce more, but what incentive is there for us to stay?”

PHM-SA representatives ranging from medical and academic doctors, civil society organisations, and health activists provided their points of view and invited students to join the movement and use PHM-SA as a medium to unlock the power of networks, to organise advocacy around public health and human rights issues they felt passionate about.

“It doesn’t matter if we use a Rolls Royce, a City Golf or a bicycle to drive fair and equitable, quality health for all, but we need to get there,” said Louis Reynolds from PHM-SA, a retired paediatrician, health & human rights activist.

About Tinashe Njanji