NHI: bled to death
Last updated: Tuesday, August 16, 2011 Print
I am rich, according to the SA government, and must pay for other people's health care. But I have been bled dry already and have very little left to give.
I am quite willing to make a contribution to the running of society by a transparent and effective government. Don't get me wrong. There's no such thing as a free ride anywhere in the world. I also know that there are many millions of people who have less than I do. But in few other countries in the world would I be considered wealthy.
The thought of contributing more makes my eyes water, because I am already being bled dry. The weekend newspapers suggested that these NHI contributions could be comparable to what people are now paying for their healthcare. If I have to pay another R2000 per month for the NHI, I am going to start hyperventilating and then have a panic attack.
What also makes my eyes water is the knowledge that the current state health administrators are clearly not doing a good job. SA's health spend is considered as high (8,7% of our GDP), and yet we have a rising infant and maternal mortality rate. Most other countries in Africa, outside of war-torn regions, are doing better then we are on a lot less cash, according to health Minister Aaron Motsoaledi in a health budget vote speech to Parliament in June 2011.
Throwing money at our healthcare system clearly doesn't work. Throwing more money at it in future will not make it any more effective if basic management issues are the problem. But the Health Minister has chosen to blame the private health care system for the problems, rather than taking a look at inherent structural problems in the public health care system.
Back to me, as a future funder of the NHI system, according to plans of the government.
I am a journalist, a profession not known for its extravagant salaries. I already pay 19% of my salary to the tax man, and 25% of any scrap of freelance work that comes my way. Then there's VAT; whack goes another 14% of my income on any purchase I make. I have been a loyal taxpayer for 26 years.
I don't know about you, but I spend my whole salary every month. In fact the last few days of the month are usually rather challenging, to say the least.
And on to property taxes of almost R5,000 per year. I bought the house 16 years ago, and am still paying it off. Now I wouldn't even qualify for a third of the bond on its market value. A sobering thought.
Every time I put in petrol I pay six different levies and taxes on every litre. My car is 16 years old, by the way.
Some food prices have gone up by 38% in the last two years, electricity costs have skyrocketed, and I avoid shopping centres unless I feel like a bout of shell-shock.
Pension pain
My personal taxes fund the equivalent of four state pensions every month, but I have to pay for my own pension plan. Oh yes, and when I retire, I get taxed on it. And to add insult to injury, I don't qualify for a state pension, because I have paid for my own. Funding my old age has become my problem.
I also pay almost R300 a month for armed response, because I suspect that any domestic crisis I might have will be shoved to the end of the queue by the overworked and understaffed Lansdowne police station 500m away from my home. And that could leave me in a pretty dire situation. Funding my security has become my problem.
I have paid UIF for 25 years and never claimed a cent. I have claimed small amounts from insurance three times in 20 years. I cannot do without insurance (almost R500 per month) as the crime rates are high, and driving around in a country where there are so many unlicensed drivers is a huge financial risk.
And now on to health care. My medical scheme costs me just over R2,000 per month. Membership is a condition of my employment. I am also no longer a spring chicken and would not like to be left to the mercy of state health care. But it now it looks as if I might have no choice if the National Health Insurance proposals can be believed. There will apparently be no opt-out option under the new system. I would have to make an extra contribution to the NHI, whether I am a member of a medical scheme or not. And this contribution will be comparable to what I currently pay for my medical scheme, weekend newspapers have suggested.
It's not that I begrudge anyone decent health care. On the contrary. It's just that I am unable to pay for it, because I am already paying for everything else.
But whenever I get depressed about my finances, which is about every twenty minutes, I console myself with the fact that there is one organisation out there who thinks I am rolling in the cash: the SA government. I remain unconvinced.
(Susan Erasmus, Health24, updated August 2011)
Read more about the Government's NHI proposals.
(This is an edited version of an article first published on Health24 and News24 in July 2009)
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Your Comments
Taxed to death
And that's not all... If you call now, we will throw in a brand new road toll for 44c per kilometre. Good luck and good night! The government is out of its depth and painted into a corner. Last resort will be to blame it all on (apartheid AGAIN) and all white people.
School fees
Then we pay school fees on top of taxes - for state schools.
Taxed too death
The following explains what happens when a few are taxed (Blead) to support many.
BAR ROOM ECONOMICS
Suppose that every day, ten men go out for beer and the bill for all ten comes to R100.00. If they paid their bill the way we pay our taxes, it would go something like this:
The first four men (the poorest) would pay nothing.
The fifth would pay £ 1.
The sixth would pay £ 3.
The seventh would pay £ 7.
The eighth would pay £ 12.
The ninth would pay £ 18.
The tenth man (the richest) would
NHI
Yeah, feel your pain Susan - the few tax paying citizens are carrying the can for everything, You forgot to add toll fees btw for us Gautengers..but on NHI specifically i don't think it's all bad. the long phasing-in and the fact that the 1st 5 years will be spent upgrading existing services BEFORE we start paying gives me hope. a lot can change if the Minister gets it right...I hope
RE NHI BLED TO DEATH
Amen to what Susan Erasmus has so eloquently expressed. I suffer with ill health and already take a plethora of chronic medications which is radically depleting our finances. My husband pays a fortune for medical aid as he is not subsidized by his employer. The NHI proposals make me shudder...what a bleak future for anyone who is less than hale and hearty. And we are all going to get old one day...Susan, I couldn't have put it better myself.
They're just getting started.
The guvver-ment isn't interested in SA succeeding in the long term, and that is reflected in all their thick, idiotic decisions. Their only interest is to milk the haves, in the name of the have-nots, line their pockets, and retire leaving the growing mess for the next generations. It's the African way. Don't expect it to get better any time soon, there's still so much money growing on that white tree, and it's so easy to pick, the pillage will continue unabated until the tree is bare.
NHI Bled to death
Why does every article lead to racist commentary? Obviously because the commentators are ignorant of the prevalent financial problems globally. Almost every single government worldwide is as inept, incapable and corrupt as our own. Race has nothing to do with it. Politicians are the root cause of the rot.
bled to death indeed
while we(south african citizen) cry they laugh all the way to italy..
I cant afford basic food on monthly basics as it run out be i get paid. Everything has tax and vat.
the government doesn't care about anyone except their pocket. How do you fight poverty when you are just adding another wound? I guess our objections dont matter cos we still have to pay toll, carbon, NHI, food, electricity, more tax, etc like it or not
Black middle class
This is going to hit up-and-coming young black people just as hard. Often they have to support parents and relatives as well as kids, so they will definitely be affected by increased costs on the medical front.
SA Govt taking us for a ride
I think almost every worker feels ripped off now. Feels like we woking for nothing, there is always some cost hitting us. we all need to join am union and strike.
Sad State of Affairs
The current conditions that exist in South Africa are unsustainable, 5 million tax payers while there are some 17 million people living on social welfare. The only way to sustain this is increased taxation, however generally this is to little benefit of the tax paying citizen as they are often forced to rely on 3rd party supplies for decent service delivery.
Truly a sad state of affairs and an inherent flaw in the future and sustainable growth of South Africa as a unified nation.
Lets not forget
Lets not forget the 100% increase government will give themselves for their great plan.
Our biggest problem is there are too many people.
The government is doing such a poor job with the money they have we as South Africans are getting robbed blind while millions of rands are being squandered by our ruling party.
It's a slippery slope and we seem to be heading the same way as all African countries that destroyed themselves.
Agree with Kale
Apart from pensioners, orphans and people on disability grants, grants never solve any problems. when it comes to claiming the child grant, you shouldn't actually have had the baby, because you can't afford it.
Never fear when the ANC is Near
I just want to say that i have GREAT hope for this country. I believe that all this tax, tolling, NHI ad apartheid cra will come to and end soon....because the ANC is going to hang themselves out to dry. Give them enough rope and they WILL hang themselves. They have NO concept of proper financial management, they just want to throw money at everything and hope its fixes the problem, well in my opinion, this allready tells me that they are clueless.
More Ideas
Want REAL job creation? !!!! how about offering a TAX incentive to all people who employ domestic or garden workers. I am pretty sure that they are by FAR the biggest job creators this economy has ever seen. Instead of PENALISING people for being successfull, how about INCENTIVISING them to share a bit of their success. ANC is slowly but surely turning SA into a communist nation. it reminds SOOO MUCH of the book ANIMAL FARM from George Orwell..lets hope that these animals dont kill us all.
Comment
The effen fundamental problem is that we get taxed for EVERY little thing to fund that monster called Government aka RANGE ROVER MAFIA.Its simple: You pay the Mafia to protect you, which they don't... It also has to do with entitlement: People in this land feel that they are entitled to have private healthcare and we must just pay for it. If I was taxed and stuff worked then fine, but I pay 6 taxes on litre of petrol and still have to put up with poor roads and traffic policing etc etc etc etc..
NHI
I agree wholly with above article. This goverrnment is clueless, absolutely clueless. With incompetent people in positions everthing will stay the same as it is at the moment, only thing that will differ is there will be money to steal. We have had enough of them expecting the whites to pay for everything when they are short, use the money that is being used for Swaziland. My co-payments on monthly medication over R200pm while I am paying over R4000pm, not to mention all the high costs further.
Corruption wating to happen
So we have aready seen how John Block was looting the current health system. If NHI collects more tax from us, there will be many more John Blocks supplying medical equipment and Malemas companies will be building the new hospitals. I would not mind paying a small contribution if I knew it was going to be managed correctly.
Root of the Cause
I might not be as clued up but and have all the facts but I believe that the need to support the " poor" should start by government educating people about family planning.If 'they' cant afford a good life for themselves why do 'they' have kids and depend on government grants, free medical aid or gov pensions. When it eventually trickels down to the tax payer that now supports them. I believe in Unity but we all need to pull our own weight.
NHI
There should be incentives for healthy people. I am a young, healthy woman who hardly ever claims on my medical aid except for the yearly check-ups, why should I foot the bill for the sick? I feel sorry for those that are ill, but it's not my problem and therefore shouldn't be my responsibility. Government should advocate healthy lifestyles and encourage the prevention of sicknesses like obesity-related high blood pressure and diabetes.
Cross-subsidisation
In the first 5 years I was on medical aid, I claimed twice. Now, 20 years later, I am om chronic medication and I have had two operations. I have always looked after my health, I don't smoke, I don't drink and I exercise. When I was young, I paid for other people, now they pay for me.
Just a thought
If everything that the government is responsible for example policing the healthcare they provide.
just to name a few. If these were run effectively then there would be no need for the ADT or private healthcare...This would also lead to tax payers who are not so reluctant to pay tax. That is what tax was ment for right? so that government have funding to provide proper health care ect ect...
Just a thought
illegal immigrants = NHI
So the poor tax payer must also pay for the 5 mil illegal immigrants in this country when they get sick!!
NHI
Why must tax payers fork out heavily to fund those whose lifestyles are making them ill. People should be held individually responsible for health problems incurred as a result of their lifestyle choices. As a self-employed person I cannot afford to get ill, so eat healthily(which can be done on even a tiny budget)and exercise. Now I'm being asked to pay for the medical bills of all those obese couch potatoes eating fries and drinking alcohol who develop hypertension, diabetes, lung disease, etc
NHI
how are we ever to survive in this country, i cannot even save a cent as i have to pay so much out, no luxuries mind you, only basics,
the cost of petrol, electricity, now toll fees, and this NHI is too much, why cant they just put people in positions who know what they are doing in goverment, i am not willing to pay for others to line their pockets,
am sorry, i am just trying to make it to look after my own family
NHI
The current health system gets driven into the ground literally by incompetent overpaid officialls in fancy cars and we must now bail them out. They must all be fired and their cars sold.
yes, but
I agree fully with the points in this article, however, there is one question. are you forced to pay all these other things? insurance? medical aid? armed response? the government is convinced that 35 million already use public health services, the same 35 million people do not have armed response and they also have no insurance. co-incidentally they also DO NOT pay TAX on their earnings. this country has 22% unemployment, now if you only work to pay the government... why bother at all?
@Milan Renaud
Milan, actually no, all governments are not as corrupt. Go live (even just travel) elsewhere and you will see what is possible!! Apartheid caused so many problems here, there is no doubt of that, and it also shouldn't be a race thing. BUT, why has this government only caused more issues in the past 17 years? Why haven't they started improving things?
NHI
on the 25th of the month I draw my earnings to go pay for school fees, security fees, petrol, tax, VAT, medical aid, rates and taxes, pension, transport, and bond and contributions to the poor souls on the side of the road and in parking lots who are worse off than I am. When I am done, my bank account will be nearly empty. By the time the 15th of the month comes, my little girl looks at me and says I'm hungry mom, I say 'can you hang on 10 more days baby?' how do i now pay NHI as well?
Had Enough
Many years ago, we were warned this would happen. We as taxpayers would have to foot the bill for the inadequacies of an incompetent government. So as much as I love this country, I am encouraging my kids to study, qualify and then leave. There is no future here for hardworking people. Sure its good to share what you have with people who don't have. But giving t all away is suicide. So go-ahead you learned people in government, do what you must to make SA just another African state.
NHI
We already have NHI. Until ANC took over we had the most advanced and competent state hospital in Groote Scheer (of Barnard fame), we had the biggest hospital in Africa (Bara), we had one of the most advanced and modern hospitals in Joburg Gen. Those are still state hospitals but the were run to ground.
ANC is clouding the issue due to their inability to run the state hospitals and other institutions. They have stolen the money required and now they want even more money from us.
What does the NHI have in store for me…
The law requires a medical aid to pay out for Prescribed minimum benefits. If the NHI is implemented, it stands to reason that Prescribed minimum benefits will be covered by the NHI and that medical aids will no longer be required to fund this. I’ ve been on many different medications for my chronic condition – but only one specific medication works well enough that I can be a functioning member of society. Without this medication, I’ ll will no longer be able to work and will be declared disabled (again!). Now for the twist – state facilities do not provide this medication since it does not have a generic and is horrendously expensive. The only similar medications that they supply, cause horrendous side effects. (Google Tardive Dyskinesia – it’ s nasty.)
So I will go from paying tax to receiving a disability pension! I’ m getting nightmares already…
come on, let's all rope in
i'm more than happy to pay more so that more people can access hospitals and healthcare. i am aware that there are people who have to scrape cents they don't have to get access to medication. in the UK people pay about 40% in taxes - we're still quite lucky. we all need to pull together. You'll be happy in future, trust me.
Selective reporting
What you have put is eloquent indeed but what you have omitted is far more grave than what you have stated. The green paper on NHI has highlighted a few facts that industry insiders have been shying away from, and thats that the current medical scheme funding model for the private sector is unsustainable. The huge price increase in the ten years to date will invariably continue to increase at an even higher rate due to inflationary pressure forecast for the medium to long term....
Selective reporting Part II
This will mean that a majority of members will simply not be able to afford medical aid and the membership pool will diminish and consequently the schemes would collapse. Then we would have a private sector that is solely built on the back of private health care which will in itself collapse due to its reliance on the medical scheme market. And ergo we will have a majority of the 16.2% of the population on private health care back on public health care and that would be unsustainable at all...
my 2c worth
Just a quick question, the money that South Africa is sending to bail out Zimbabwe and other neighbouring countries, can't that rather be used to help its own citizens with medical care? Just a thought....
Curios question
How much of the government employees are taxed, and have to pay these expenses, including the nh1 ?
Shouldn't they start contributing as well.
nhi
this nhi thing is a joke i was wanting incluin and keepet on getting told to put my name on a list but 6 months later i was not on it and it was cheaper for me to go back to the uk then pay about R2500 per month for meds
Housing plan
stay in a shack, its cheaper
ride a bike to work, save on tolls and petrol
use a sangoma, save on medical aid
buy things from a indian or chinese, there is no tax there
I'm out of here
this is ridiculous they are squeezing us until we squeak! I'm off to Australia... Taxes might be high but hey at least I benefit from ALL of it! $800 a year per child to use on education extras like computers. Its like winning the lottery! Just try and treat one illegal immigrant on the NHI and I will be toy-toying all the way to Oz.. Bad enough we have to carry our own unskilled, unmotivated, I'm-entitled bunch!
Oh dear
Thing is I really do wish they could get it right because between private healthcare and fleecing medical aids we are being robbed... But really now does anyone expect them to manage this successfully? Its just going to end up being another honey pot for the likes of Malema and Zuma to lick clean... It will be the poor, the children who will suffer the most - paying with their lives.
NHI
Happy to pay the NHI tax so long as it goes to sterilising the bstrds who breed like rabbits and then expect me to support them. Screw this I'm going to start by giving up my job and banging on doors in townships looking for a handout
No more handouts to anyone
I now absolutely refuse to give anything - no matter how small - to any car guards, beggars, anyone asking for a handout or a donation gets the door slammed in their face (figuratively). I will not give anything towards anything. Even a loaf of bread is asking for too much from little ol' me!
Shoulders to the wheel guys (real damage of apar..
takes money to achieve quality in anything. I will use our school systems for example. Model C schools achieve top results every year because we pay school fees. a high school were my son is attending collects about R 14 million every year excluding stationary and Books from parent and I compare this to a non fees paying school in deepslot were my friend is headmaster it receives about R 900 000 pa from Gorv for stationary and general running of the school. this is the results of unequal society
The Patriotic Citizen
Well we have a people led government. 1 man 1 vote. My apology to those who are rich or fortunate and those honest citizens and patriotic people in disbelief. Many inequality exist within our country. We can shout and scream or run away to other countries but at the end of the day we all have to live in one country under the same rules. So guess what the poor were left behind and unfortunately its blacks (Black, coloured and indians) and yes the white women. So people lets fix it sugest somethin
Summary of new and proposed Costs - Gauteng vrsion
So in addition to: 14% VAT, Income Tax, Several Fuel Taxes & Levies, Existing Toll roads, SDL, UIF, Pvt Medical & Pension, the following will be added or are being planned to be added:
- NHI (Aprprox R1000 to R2000 pm)
- Additional Tolls if in Gauteng to the tune of 40c p/km(Approx R500 to R800 pm for avrge user)
- If you are white: Wealth Tax for 2 years or so (Our new black masters will decide how much)
That means approx 75% of your salary gone if you are white and live in Gauteng. Nice!
NHI
If people who have medical aid has to pay the amount they are paying now towards NHI, so what is a point to have private medical aid? we migth just cancelled and contribute towards NHI since is compalsory, and private medical aid will loose business if that's what government want.
No More!
I will NOT pay for NHI, by the 4th of every month I have to worry where I am going to borrow money from to support my family for the rest of the month. Just because I work and earn a salary of 4000,& have a medical aid because it is a condition of work, does not mean I am rich or have extra or a easy lifestyle. I can really use all the moneys you as the government drain out of me, I hope when you have your five star dinner tonight you will think about all the others you taking their food from.
taxes
Dont forget all the immigrants who have fraudulent ID's who can access the state grants.... White people make it seem as if they are the only ones paying taxes and non blacks are exempt. For as long as we look at this issue from a race perspective will will never be able to enforce any changes... This is a bread and butter issue, not just for the pink skinned but also us brown skinned people.
NHI
You cannot legislate the poor into freedom by legislating the wealthy out of freedom. What one person recieves without working for, another person must work for without recieveing. The government cannot give anything to anybody, whithout taking it away from somebody else.
You cannot multipy wealth by dividing it!
Misleading article
Some misrepresentations in this article: 1. If you read the green paper you’ ll see that NHI is explicitly not just about “ throwing money” at the problem – but goes along with an extensive revitalisation programme. 2. Facilities will only get NHI status once they reach certain strictly defined standards – i.e. you mislead by ommition. 3. The minister’ s criticism of private healthcare costs is justified, but you are simply wrong by suggesting that he is ignoring the structural and managerial probl
continued
… by suggesting that he is ignoring the structural and managerial problems in the health system. 4. As a journalist I would expect you to be more critical of the claim that you’ ll end up paying the same as you are paying for med schemes now. That estimate is based on some very wably assumptions and is probably an overestimate.
Article vs. column
James, this is an opinion piece - not an article. There is a huge difference between the two.
Opinion vs article
Richard. The fact that it is opinion doesn’ t mean misrepresentation is acceptable. We need to engage with the NHI process based on the facts, not based on knee-jerk reactions that are uninformed as to the actual plan on the table. The author is a health journalist. When she writes an opinion piece on NHI she should at least have read the green paper – which she clearly hasn’ t.
Pharmacy Rocks! I mean it!
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