The business of health: How the challenges could scupper the NHI

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South Africa has a healthcare dichotomy, and the inability to reconcile the needs of both public and private interests has led to a deepening crisis of inequality, writes MaxAlias

South Africa has a healthcare dichotomy, and the inability to reconcile the needs of both public and private interests has led to a deepening crisis of inequality.

As with any other critical services the country requires, and one that is enshrined in our Constitution as a human rights imperative – education, electricity, water, housing and health – the engagement of the private sector carries with it a fraught morality. At the coalface sits the citizen, the person in medical need, who is neither considered nor catered for beyond the provision of a service that they have no power in negotiating and can measure neither the outcome of nor the quality of the care received. They are unable to do this as there is no mechanism within either private or public health that gathers this data.

The Competition Commission’s recommendations in this regard are wide-ranging and deep, and it warns that market failures will persist if a partial intervention only is applied. For practitioners, there are interventions to promote competitive pricing and a move away from fee-for-service contracts.

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