Since the lockdown began in South Africa on 27 March 2020, only 207 additional critical care beds and 350 ventilators have been added in the public health sector. According to a recent article
on News24, there were 2,512 critical care beds available in the sector on 10 April, the number given by the then acting Director-General of the Department of Health, Dr Anban Pillay; as of 3 June the number was just 2,719.
If true, such inefficient preparation will mean the public health sector will be woefully underprepared if South Africa experiences a massive spike in COVID-19 cases. Further, such a massive failure of implementation makes light of the sacrifices that were forced upon millions of citizens and businesses.
Ostensibly, the purpose of the lockdown was to give the government critical time necessary to increase its capacity to handle the COVID-19 pandemic. In order for the country to better handle the inevitable flood of cases, the government fell for the false notion that it needed put a freeze on the economy, and more fundamentally on people's lives – building capacity was the rallying cry. But as history has shown us time and again, placing government in charge of something and wanting more of that thing to be produced has the opposite effect. Of course, unless we are talking about poverty: When government intervenes in the economy to 'fight poverty,' the negative effects tend to drive more people into poverty and keep them there.
It appears that the time 'bought' through the lockdown – time taken from an economy that was already on its last legs before COVID-19 – has been squandered and ultimately counts for nought.
In a previous article
, I drew attention to the fact that close to 1 million jobs could be lost across Gauteng. South Africa faces a potential 22% decline in GDP. Billions of Rands in economic activity have been lost. And more than that, people's fundamental freedoms and potential to improve their lives was summarily stunted. The increasing poverty and hunger around us every day are indicative of the wrong policy approach. Add to that the frustration of knowing that time has not been well-spent in increasing healthcare capacity and readiness.
South Africa's lockdown, one of the most authoritarian and inflexible in the world, has impacted very detrimentally on all of us, but it has been most harsh on low-income households. This is always the case when the government intervenes in the economy: poor people suffer the most. Instead of allowing businesses and customers, from the largest corporates to the person trying to make a living in one of our many townships, to adapt and continue operating, virtually every economic freedom was stripped away. To remove people's ability to earn a living, to such an invasive extent, is incredibly cruel.
While it is clear that grave mistakes have been made during the lockdown, both conceptually and in implementation, our attention should not be focused only on the past. We must also be exceedingly wary of, and agitate against, renewed calls for South Africa to implement the National Health Insurance (NHI) scheme. The NHI aims to monopolise the management of the healthcare needs of over 55 million people. A monopoly of the management of healthcare by government will always result in myriad inefficiencies, continually expanding costs, and declining health standards.
Before the lockdown, wrong policies and ideas, such as high barriers to employment, meant that over 10 million people were unemployed and could not find work. Businesses were squeezed out of existence because of an inconsistent energy supply specifically, and, more generally, SA has an environment opposed to wealth creation. From a broader philosophical perspective, South Africa has been blighted by the acceptance of government control – government at the centre of our commercial, communal, and personal lives.
If we think that subjecting people's healthcare needs to that same perspective will not result in similarly detrimental consequences, we are truly living in a fantasy world.
The fact of the matter is that there is zero fiscal room for the government to implement a plan under which it
will pull the strings, large and small, of all citizens' healthcare. On top of that, we have witnessed the problems associated with government trying to decide for millions of people what specific path they should take when trying to handle a pandemic.
The Chinese government repressed information of COVID-19 in the earlier stages. Mixed messaging from the US government severely hampered the ability of the medical profession to react quickly enough. The overarching point is that no government should ever pretend that it has a monopoly on information. It must never assume that its bureaucrats have the ability to decide for individuals how they should tackle certain challenges.
The proper path for a government to follow is to provide as much information as it can to the people, allow the private medical sector to invest and increase capacity, and hold back on restricting people's civil liberties. Fear is never the right basis from which to tackle any crisis. It distorts our reason and renders us incapable of acting with the necessary precision.
Forming a single, centralised monopoly to replace South Africa’s private healthcare sector is not the answer to the current problems facing that sector or for upgrading the ailing, dilapidated public health sector. Centralising any part of an economy increases inefficiency and ensures an endemic lack of innovation. It also increases the likelihood of corruption, as different groups vie to control the levers of government influence (something we have to address, if South Africa is ever to become truly attractive for foreign investment and real capital formation).
Thuli Madonsela's recent open letter
to President Ramaphosa was heartening to read. All South Africans who are concerned with a government acting with impunity toward its citizens, especially the poorest among us, should make their voices heard and increase the pressure on government to own up to the grave errors it has made.
We must not fall into the trap of allowing the government to seize control of yet more of our lives. If we want to treat each other with meaningful respect, we must allow each other to live as free from state interference as possible. Now is the time for South Africa to try something new: The truly radical and transformative idea of individual and economic freedom.