National Health Insurance falls short by not addressing disease prevention means – OPINION PIECE

South Africa

The National Health Insurance is meant to address inefficient public healthcare in SA and it remains to be seen whether such reform will address the problems that are rife in public healthcare. Some argue that the crisis in public healthcare is not so much clinical than it is structural.

For instance, patients’ experiences in public healthcare facilities are awful due to an uncaring staff who do not treat patients with dignity and respect.

We also know that in most provinces health facilities are dilapidated due to lack of maintenance, but the shortage of medical supplies is by far the worst – public healthcare is simply unreliable.

Yet, all these issues which affect our healthcare significantly could be better managed now, even before NHI reform. The NHI must not be viewed as the magic that will address poor governance, for example.

Therefore, the status quo, as a result of poor governance and lack of capacity, may remain, even under NHI.

Reports further suggest that other major problems with NHI is that it makes no case for mental health care and substance abuse, according to Prof David Sanders, but what struck me the most was that the NHI is also silent on prevention. Managing preventable diseases should be a priority for government as it is more cost effective.

People need to be made aware about certain diseases and the steps to prevent them. And the same goes for treatable diseases. Patients do not have to die when treatment is available, only to be accessed.

What I’ve realised though is that feminism has made great strides globally to improve women’s wellness and healthcare due to greater access and considerable public healthcare awareness.

Women are much more aware of their bodies, such as how to detect a lump on their breast, unlike before. This means they are able to access healthcare on time.

But even so, there is a lack of male healthcare awareness – especially in mental illness and substance abuse – which the NHI is silent on.

This is problematic because violence, for instance, is connected to poor healthcare and mental illness.

The high male suicide rate is also linked to a lack of male healthcare responsiveness. There is consensus that most men suffer untreated mental conditions, leading to greater prevalence in male suicide.

Men do not receive treatment for depression, which is responsible for more than half of suicides, according to various research. “Over half a million men take their own lives globally [a year] – that’s one every minute,” says the Men’s Foundation of South Africa.

The World Health Organisation (WHO) pronounces similar figures and found that close to 800,000 people die due to suicide every year, which is one person every 40 seconds.

WHO labels suicide a global phenomenon, but says that “effective and evidence-based interventions can be implemented at population, sub-population and individual levels to prevent suicide. There are indications that for each adult who died by suicide, there may have been more than 20 others attempting suicide.”

There are misconceptions that people with mental illness or disabilities do not need access to healthcare or disease prevention.

One of the reasons women’s healthcare has improved globally is that feminists believed “the science of health was embedded in a women’s whole existence and social context, from her social class and race, to her sexuality and her vulnerability to violence,” according to academic Claire Potter.


Source – SowetanLIVE

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