Showing posts with label NHI South Africa. Show all posts
Showing posts with label NHI South Africa. Show all posts

Tuesday, 13 February 2018

SA is Not a Democracy part 1

Democracy is a loose term. It can mean different things to different people. It is a loaded word and has been used and abused to promote ideologies and organisations of all types. Heck, even North Korea considers itself a democracy!

The word democracy comes from Greek and means 'rule by the people.' See why it is a loose term? 'Rule by the people' can mean a variety of different things. Today when we speak about democracy we are usually referring to representative democracy, where we choose leaders in elections who are supposed to represent our interests. Great! So different groups of people with different interests elect leaders, so that everyone is represented in the government and those leaders sit and have big discussions so that the country is run in the way that is best for everyone.

Wrong!

The first problem is that here in South Africa government doesn't make decisions by discussion and compromise. It makes decisions by voting and the vote is won by a simple majority (excepting of course for amendments to the constitution.) So if a party has 51% of MPs, that party holds all the power. And since the number of MPs is proportional to the number of votes, 51% of the voters can effectively control the lives of the other 49%, given how much power the government has over individuals in our country.

The next problem is that only 16 million of our 55 million population votes, which effectively means that just over 8 million people can control the lives of the other 47 million. I'm sure most of you are starting to see a problem here.

Now the nature of our ruling party makes the above problem much worse. Most of the country votes blindly for the ANC. They are almost guaranteed to win the elections no matter what. The ANC has over 700 000 members, organised into about 5000 branches. There are about 500 other voting delegates at elective conferences, but for simplicity's sake we will assume there are 5000 branch delegates who vote to elect the ANC leadership and thus their MP's. Each delegate needs 51% of his branch vote, and each ANC leader needs 51% of the delegates' votes. This means, that in the extreme situation 26% of ANC members can choose the party's leadership,and thus the path the country will follow. Doing the maths, that's less than 200 000 people determining the destiny of more than 55 million.

These calculations are both rough and simplified, but they illustrate just how few people are making the decisions that we are supposed to be making as a nation. And even then, we are still assuming that these elected leaders act according to the will of the people who elected them.

I know this has been a bombardment of figures and statistics, so let me make a final point for those who don't really care for numbers. Our situation is summed up very well by looking at the times of greatest political change. With Jacob Zuma about to be ousted after years of controversial and morally bereft leadership, it is clear that more change in the country comes out of the ANC elective conference than any other occasion, including the national elections. That is not democracy.

Thus we see that in spite of the endless propaganda bragging about our democratic ideals, South Africa is not really a democracy at all. But then what is a true democracy? The Greeks didn't just give us the word democracy, they gave us the whole concept. In part 2 I will explain, referring to the ancient Greek model, how we can have a real democracy.

Wednesday, 12 July 2017

A Symptom of Chronic Stupidity

Free Stuff!

That caught your attention, didn't it? The power of the word "free" is astounding. It always gets us excited even though our most basic intuitions tell us there must be catch. As South Africans we keep falling for this trap, free housing, free electricity, free education and now free health care. When will we realise that nothing is ever free?

Away from the State Capture vs White Monopoly Capital battle which is both capturing and monopolising the headlines, news regarding the progress of the NHI (National Health Insurance) has managed to attract some attention, though certainly not enough. For those who have no idea what I'm talking about, the ANC has big plans to create a national, single payer healthcare system similar to Obamacare, or the UK's NHS. The goal is for it to be implemented by 2025, but it has just popped up in the headlines because a couple of milestones in the planning stage have been hit.

This system spells disaster for our country. I know there are many who admire other countries' national healthcare systems and I know that there are many South Africans who are proponents of the NHI because they want to see universal access to quality health care. The foremost criticism of those who oppose the NHI is that they supposedly don't want such. I will say now that I am completely in favour of universal access to quality health care, and it is for that very reason that I oppose the NHI. I admire the intentions of those who expect it to be a great help to the poor, but the road to hell is paved with good intentions, and I am not interested in living in a socialist hell. The NHI is just another brick in that road.

My biggest concerns are the moral issues regarding a government-administered single-payer health system, but first let's look at the practicalities. In terms of affordability, well, it just isn't affordable. We already have a shrinking economy, too much debt and high taxes. There is simply nowhere to pull the R100 billion from without causing extensive damage to our fragile economy. The immediate response from the short-sighted is "Tax the rich!" but the more we tax tax the rich, the faster they are going to leave sunny, socialist South Africa for greener pastures overseas, further hampering our ability to provide access to quality healthcare. Then we have a problem with lack of resources. We have neither the infrastructure nor the human resources, i.e. doctors, to bring the healthcare standards for everyone up to the standards of the current private sector, so in spite of the huge price tag, the standard of health care will improve only marginally for poor, but take a massive nose-dive for the rich. And no, there is no opt-out option for the NHI. Everyone is part of it. So the net result of this legislation will be a mass exodus of educated, skilled middle-class systems, to countries where they can obtain their own affordable quality healthcare.

One of the reasons healthcare is so expensive is because the healthcare profession is like an exclusive club. There are many, many capable, aspiring doctors who cannot get into medical school because of arbitrary and meaningless selection processes and lack of space, all while Blade Nzimande brags about blocking the building of a private medical school, which could provide us with many more doctors. Then there are also all sorts of unnecessary government restrictions that make access to affordable medicine impossible. Government needs to cut a whole lot of red tape, and the cost of healthcare will come down significantly.

And now to the moral issue. The government simply does not have the right to interfere with private citizens choices regarding healthcare, health insurance or anything related. It does not have the right to steal from the rich to subsidize the poor in this regard. Health care is not a right. Health care is a service and one cannot have the right to the services of another person. A baker can expect to bake for whom he wants to bake and a painter can expect to paint for whom he wants to paint, but doctors and nurses, who invest thousands of hours and hundreds of thousands of rands into their education must provide their services to whom the government dictates? We cannot make slaves of our healthcare professionals any more than we can make slaves of anyone else.

This post is already getting long and I have only just touched on some issues. Please comment if you want more information regarding any of points discussed. In conclusion, it is not more forceful redistribution that we need, but a growing economy, a free economy, that will allow people to access quality healthcare for themselves. Yes, I believe everyone should have access to quality healthcare, but it is not the governments responsibility to provide it.