Welcome to the Doctors' Portal
00:00 Sunday






News Description

DAILY NEWS CAPE ARGUS THE STAR When Louis Washkansky was operated on by Dr Christiaan Barnard at Groote Schuur Hospital in Cape Town in 1967 to become the beneficiary of the world's first heart transplant, he didn't have to worry about who would pay for the operation. Washkansky didn't even have to know how much the operation would cost. The operation was conducted at Groote Schuur by a team of doctors led by Barnard, and the total cost, including the salaries of all the health care professionals who worked on the operation, was borne by the state. About two weeks ago, Professor Mashudu Tshifularo and his team at Steve Biko Academic Hospital per formed another world first. Tshifularo conducted a middle ear transplant on a patient who had lost hearing. The patient's hearing was restored. What an achievement and scientific miracle! Again in this case, the patient did not have to know how much the operation would cost. The entire operation was funded by the state. Advanced 3D-printing technology was used to print the bones – the hammer, anvil, stirrup (the three ossicles) that make up the middle ear. In both cases, if the patients were forced to pay for the procedures, either they were going to fail to do so, with disastrous consequences to their health, or they were going to have to use most of their life's savings, with catastrophic financial outcomes. Nobody should be put in such a situation. The irony is that in the same year that Barnard performed this world first, another event took place which would have the effect of cancelling the benefits that Washkansky enjoyed from extending to every South African who needed such help. For it was in 1967 that the first Medical Schemes Act was proclaimed, ushering in an era where you have to have a certain level of income before you can get good-quality medical care, otherwise you perish. It was also an interesting coincidence that Tshifularo's 10 years of research climaxed in March, the month during which we celebrate human rights. Our constitution identifies access to healthcare as a basic human right. When the governing party adopted the National Health Insurance (NHI) at its Polokwane conference and endorsed the NHI at subsequent conferences in Mangaung and Nasrec, the main reason was to give meaning to the constitutional obligation that identifies access to healthcare as a human right. In the same breath, the UN adopted universal health coverage, for the same reason: to make sure that nobody suffers catastrophic expenditure when they need to use healthcare services. This is why people who understand the constitutional imperative of healthcare as a right are unflinching in their resolve that NHI needs to be implemented. The introduction of the 1967 Medical Schemes Act at face value looked like progress in a developing country. But in essence it was laying the foundation of the worst form of inequality in healthcare the world has ever seen. This is because while the constitution says healthcare is a basic human right, which must be accessible to all South Africans in our country; the Medical Schemes Act, on the other hand, was saying that first you have to be employed, and also earn a particular level of salary, in order to access that healthcare. The consequence of that act is the gross inequality in healthcare that we see today. The realisation of this phenomenon was reflected as far back as 1978 at the World Health Organisation's Alma Ata conference. It was there that a declaration was adopted, which stated: "The existing gross inequality in the health status of people between developed and developing countries and within borders of the same country is politically, economically and socially unacceptable and is of common concern to all." Unfortunately at this moment, South Africa is the country where this form of gross inequality is the most glaring of all countries. As we remember the victims of the Sharpeville massacre, who should inspire us to create a more equal society, we should also reflect on how, as a country, we are ensuring that healthcare is a basic human right that can be accessed by all without regard to social or economic status. Our position, as the Department of Health, is that NHI is the equaliser of the unequal factions of our population; those who have medical aids can access healthcare anywhere, in public and private settings, whereas those without are restricted in what healthcare is available to them. It is understandable why organised labour is lambasting the Department of Health for what it sees as delays in the rollout of NHI. After all, unions represent the working class, who should benefit hugely when we introduce a system to ensure the doors of access to healthcare are opened to all. Dr Motsoaledi is the Minister of Health
Created at 2019/04/01 11:06 AM by Mediclinic
Last modified at 2019/04/01 11:06 AM by Mediclinic