The recent passing of the National Health Insurance (NHI) Bill in Parliament has led to much angst and uncertainty. While the developments will materially transform the healthcare sector in the country, we should not lose sight of the opportunity that is presented.
Before one gets caught up in the politics and vested interests, we believe that we should bring this back to one single question and answer:
What is South Africa’s greatest asset?
The answer is simple – its people.
Unfortunately, our greatest asset has struggled with chronic under-investment in our healthcare system, and this has translated into a public healthcare system that does not perform on par with global standards.
The resulting impact on workplace productivity is costing the economy over R200bn a year, manifesting in the form of absenteeism, presenteeism and chronic disease.
While the social impact of HIV and Tuberculosis are well documented, we need to recognise that South Africa struggles on multiple levels when it comes to healthcare. Think for a moment about the following:
• Diabetes is the leading killer of women in South Africa and second highest for men and much of this can be attributed to diet, weight and physical inactivity.
• Alcohol abuse has spiked in South Africa and is way above global averages
• Data gathered by Sapien Labs as part of its annual “Mental State of the World Report” showed that 36% of South Africans were reporting mental health issues and this is reflected in the data out of the South African Depression and Anxiety Group (SADAG) who field up to 2 000 calls per day with 1 in 5 being suicide related.
Whether we are talking about “SA Inc.” or your own business, these are the people that are on the frontline and on who we are dependent on delivering economic performance. The reality is that they are at breaking point and the longer they are excluded from the healthcare system, the more this crisis worsens.
The kind of figures illustrated above lead to the dynamic that we are currently seeing in South Africa. Demand for healthcare services because of environmental challenges are rising while the number of qualified healthcare professionals are not increasing quickly enough to keep up with demand.
A low-growth economy is further exacerbating this situation with an increasing number of employers not compelling staff to join a medical aid. Recently released industry research suggests that less than 15% of medical aid membership in South Africa is voluntary. South Africans are clearly not prioritising healthcare, resulting in stagnant growth in medical aid membership despite decreasing population health.
Across the board, the healthcare sector reports that one of the biggest challenges they see is the late-stage diagnosis of critical conditions. This in turn pushes up hospitalisation costs and insurance claims.
This is resulting in access to specialist healthcare becoming increasingly unaffordable – a situation which the medical insurers have recognised and attempted to resolve through the introduction of innovative new products. A good example is Momentum’s Health4Me offering which allows organisations to apply a “building- block” approach to healthcare cover solutions for their lower incomes staff.
It is crucial to recognise that the introduction of health insurance products alone cannot adequately address the pressing healthcare crisis. Health insurance products are not a substitute for medical scheme membership, as they do not offer the same level of cover and protection that medical schemes do.
At the same time, South Africans are facing pressure on their income as interest rates rise and inflation pressures take a bite out of already limited resources.
The passing of the NHI bill has come at a time when South Africans are physically and mentally exhausted. Politics and vested interests are creating an emotive environment with the ordinary South African caught in the middle.
We cannot lose sight of the end goal: A healthier South Africa unlocking our economic and social potential. We do know that there is excellence throughout the healthcare ecosystem. Whether it is specialists, allied health professionals, medical health facilities, claims administration or funding – we have built pockets of excellence and the goal should be to amplify, not dilute these.
If we agree that the mental health crisis is costing South Africa R200bn each year, we should recognise that the private sector has invested significantly in understanding these issues and incentivising healthier mental behaviour. These learnings implemented in a universal healthcare system will prove invaluable in controlling costs and protecting the future of health in SA.
There is so much to gain if we put aside the political agendas and focus on how we make SA healthier again without losing the intellectual capital we have developed up to now. By doing this we can create an equitable system that will enable more health for SA for less.
Whether you are looking at it through the lens of “SA Inc.” or as an employer looking to protect your investment, the reality is our people are our greatest asset and by bringing the healthcare debate to the fore, we are in a position to re-imagine a healthy future for the country.