Business Day column: Health minister uses illusion to talk up benefits of the NHI

20 October 2016
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Despite our differences, Health Minister Aaron Motsoaledi and I have something in common.

He calls me a clown. I call him misguided. He is authoritarian. I am libertarian. He thinks consuming sugar, tobacco, liquor, fast food, salt, fat and a sedentary lifestyle as coping mechanisms for depression, loneliness, stress, grief and unpopularity are unhealthy. I think contentment, satisfaction, happiness, leisure and pleasure are healthy. For him, adults are subjects who must live as he sees fit. For me, adults are civilians who must live as they see fit.

For him, people are chemical processes to be perpetuated by medical science. For me, people have spirits, minds and souls to be enriched by satisfied needs. He wants to coerce supplicants. I want to empower informed choices. He sets a bad example by appearing overweight and sedentary. I set a good example by healthy living. He says competitive prices are "excessive". I say they are ideal. He boasted about being a nanny-state nanny. My children boasted about being the boss of themselves.

What could people with such opposing paradigms have in common? Magic. Yes, magic. We are both magicians. I am an amateur, whereas he is a professional. I perform mundane tricks; he performs high-end mental magic.

I attended three of his mental magic shows. They were not billed as such. Officially, they were meetings of business people, with him as guest speaker. His performances mesmerise the rich and famous. Because he is so good, the brightest among us are impressed. As with the best magicians, we are taken in. Only after careful reflection do we realise what happened.

When he told them he was going to magic away their health-care savings, they did not realise what he was saying. They applauded. When he said he was going to spend their money on other people, his generosity transported them. When he said they would endure catastrophic public health-care and the masses would overwhelm private hospitals, their eyes sparkled.

Magicians use distraction to divert attention from what they are really doing. Instead of being disgusted by pictures of thousands of ghastly facilities under his watch, his audience was elevated by pictures of half a dozen contrived "model" clinics.

The health-care sleight of hand is so effective that the DA never saw what was in plain sight. It rated Motsoaledi the best minister despite DA health activist Jack Bloom routinely proving that health-care in the hands of the state is in a hell of a state. Since there is no deafening chorus of concern from health-care providers and insurers, we must assume that they too do not hear what they are told.

Gullible people think something called "insurance" is insurance, even when told that, under National Health Insurance (NHI), health insurance will be banned, and that insurance premiums and medical scheme contributions will be expropriated. When the rich, whose taxes fund Motsoaledi spend, are told that they will not be allowed to spend what is left on themselves, that it will be "pooled" into the health budget, they grin with glee.

Like magicians using deceptive smoke, mirrors, props and patter, the NHI illusion relies on the lie that it is "unfair" for private "health spend" to benefit those who spend it, for private hospitals to benefit those who fund them, or for medical schemes to benefit members. If Motsoaledi magic is applied in other contexts, your personal restaurant, house, car, holiday, jewellery, clothing, grocery and wine "spend" will be "pooled" for magical reallocation too.

• Louw is executive director of the Free Market Foundation.

This article was first published in Business Day on 12 October 2016



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