Hurrah for national healthcare!
- Ivo Vegter
- 05 Oct 2010 05:39 (South Africa)
With great relief, I read the news that the South African government has solicited the help of comrade-bureaucrats in the UK to advise it on the implementation of a national health insurance plan.
We need such a thing urgently.
Recently, Sapa reported: "By 2015, 80 percent of South Africa's fresh water resources will be so badly polluted that no process of purification available in the country will be able to make it fit for consumption."
This is no surprise, of course. Two-and-a-half years ago, I wrote a blog post warning that our water would soon be undrinkable, thanks to contamination of water sources, failing water treatment facilities, and a decrepit system of aging pipes and pumps that has not remotely kept up with demand.
In that post, I quoted an article written by Peter Wellman for the African Eye News Services more than a decade ago, raising the red flags: "it is clear that all is not well in the water supply and sanitation sector in South Africa."
If this sounds familiar, it is because Eskom went over the cliff in the same way. Like a great big election campaign van, it barrelled merrily along, its megaphone blaring about how great an example electricity was of a functioning government service. As it approached the cliff of supply shortages that bars the way of every government service ever invented, the juggernaut passed warning sign after warning sign. Nobody was shrewd enough to turn the wheel or apply the brakes. Cartoon-style, it has ended up suspended from a tree growing from the side of the cliff: low demand from a sluggish economy has relieved the worst of the blackouts, temporarily.
In 2006, then-president Thabo Mbeki told us, "There is no crisis." He was talking about electricity, two years before the blackouts hit. In 2008, Lindiwe Hendricks, then minister of water affairs, told us, "I can categorically say that we are not facing a water crisis, or a water-contamination crisis."
So anyway, we're all going to get fascinating diseases like amoebiasis, botulism, cholera, cryptosporidiosis, dysentery, fasciolopsiasis, gastro-enteritis, hepatitis, poliomyelitis, severe acute respiratory syndrome or typhoid fever. Instant death. Just add water. Unless you can afford eight glasses a day of imported beer.
The private sector will charge us lots of money to treat such conditions. They will say that you cannot put a price on not dying before the week is out. They will claim that they have to spend money developing, producing and distributing drugs. They will spin stories about having to pay doctors high rates so they don't leave for Australia to treat the wealthy descendants of thieves and heretics.
This just won't do. Instead, we need a communist system like in the UK. There, the state decides who will get what healthcare, why, where and when. Call it Big Mother, if you like. Since we will all need equally much healthcare equally soon, this egalitarian approach makes perfect sense for South Africa.
In Britain, patients gripe that they don't get enough healthcare, don't get it when they want, don't get efficient service, and don't get consulted about what they need. Of course they do. Have you ever met an Englishman who doesn't complain all the time? With weather and newspapers and teeth like theirs, you'd also be a whinging sod.
They don't get consulted, they say? What arrogance! A patient consults a doctor, in a doctor's consulting room. Not the other way around. Since when does the patient know medicine? Defer to the expert, is what an intellectually humble person would do.
In South Africa, many people still use homeopathy. This is based on the notion that water remembers the good stuff that's been in it even when it's been diluted to death. I have news for them. The only thing our water will remember by 2015 is how much shit has been in it. Homeopathy will stop working, even if you once believed it did work.
Those who weren't so irrational might be more reasonable in their demands for medical treatment, but did they spend seven years at a university to get an official licence from the government? Of course not. Asking patients what healthcare they want is like expecting a motorist to know how to build a car when all they want is to get to work on time.
As for efficiency, it's not as our healthcare is efficient now. We're paying some nurses to let babies die, and we're not paying other nurses who couldn't get to work because of intimidation by striking public servants. That's hardly efficient. But let's consider real numbers.
The UK's national health service costs it around 7.1% of GDP. Using the latest World Bank GDP figures and current exchange rates, this puts the UK's healthcare costs at about R1,100 billion a year. A comparable service for our slightly smaller population would cost about R900 billion a year. That's nine times what the government spends on healthcare today, and more than twice what eggheads estimate it will cost per year by 2025.
Of course, we have to face facts. Our GDP is only R3,500 billion. A British-style system will swallow more than a quarter of our entire GDP. Every year.
So we'll have to make some extraordinary savings. The government has made a good start by not paying nurses who wanted to go to work during the strike but couldn't. Paying the rest is just wasteful, so we might as well not pay nurses at all. It's not like porters and cleaners haven't seen the basics often enough to achieve the same basic outcomes, and there's always private charity to fall back on.
We can also deploy an army of government health inspectors. This will create hundreds of thousands of new jobs, which will help to create new wealth while it enforces savings. To spread the largesse, they could wear uniforms made by our long-suffering domestic textile industry and drive subsidised cars made in the notoriously unemployed Eastern Cape.
These footsoldiers of the health revolution would go door to door, lightening the burden on the government by checking that we do not smoke, drink, eat fast food or lead sedentary lifestyles. Inspectors could levy fines for improperly installed diesel generators, smoky stoves, dirty kitchens, loose extension cords, slippery floors and draughty doors. Inspectors will no doubt think of many more such revenue opportunities, both for public and personal profit.
We can economise even more by firing our expensive doctors, so they can go to Oz without feeling guilty. To replace them, we'll import communist slaves brainwashed in the medical arts in Cuba or North Korea. After all, how difficult can it be to be a doctor? When you prick a starving peasant, does he not bleed? Our new doctors might not speak any of our official languages, but they'd be dirt cheap, prepared to work 18-hour shifts just for the privilege of not living in their own countries.
South Africa could pull it off for much less than profligate and demanding British imperialists pay per person. That way, we might even keep VAT and income tax increases in the single digits.
It is true that even basic government services such as electricity and water are a disaster. It is true that in any massive new expenditure mandate, there are equally massive opportunities for corruption. These observations may, in the narrow minds of racists and pessimists, create doubt about the likely success of a new health bureaucracy designed to cure the diseases caused by the original failures. But what's the alternative? The meagre, last-ditch efforts of our government might as well be mustered against the only enemy we will have five years from now: water-borne death.
Still, while applauding this initiative, I'm going to quietly ask my private physician for a forwarding address, before he packs for Perth. Oh, wait. Australia won't let me in if I have cholera, hepatitis or typhoid fever. Imperialists! DM
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