musings on healthcare

lately in my sociology of industrialisation class, we’ve been discussing the issue of national healthcare, and as if this weren’t already such a contentious issue in the united states, it truly rises to the forefront of individuals’ attentions, minds, and hearts here in south africa. in 2007, the expenditure for public sector healthcare totalled 59 billion rand, serving 40 million denizens. on the other hand, the expenditure for private sector healthcare totalled 67 billion rand, serving 7 million of the country’s wealthier residents. put another way, in 2007, the 8.5% of south africa’s gdp spent on healthcare; 3.5% of it went to public sector healthcare, whereas 5% went to private sector healthcare. the annual amount spent per person within public sector healthcare is 1,400 rand, whereas the annual amount spent per person within private sector healthcare is 9,500 rand.

the extreme disparity in the amount of money allotted toward healthcare in the public versus the private sector has resulted in a remarkable gap in the standards of health between south africans – and understandably so. after all, medicine has undergone a process of commodification – the result of this being that, if you can afford it, you can obtain the best healthcare possible. if you can’t, then you’re screwed.

this issue certainly sparked a debate amongst the students in my sociology class, and quite frankly, i wasn’t too enthused about the solutions they proposed for remedying the situation. one of the more outlandish (in my opinion, at least) solutions proposed was a reassignment of white medical staff to facilities in majority-black neighbourhoods, and vice versa. i wasn’t terribly keen on this pitch, namely because it works under the presumption that all white people are rich and all black people are poor (a supposition that’s becoming less and less true in post-apartheid south africa), but also because it presumes that whites inherently provide better healthcare than blacks (it should be noted that the author of this suggestion, in fact, is black).

another suggestion that i was equally nonplussed about, but seemed to be met with a greater level of amenability by my classmates, was that of eradicating private healthcare altogether. under this proposal, all of south africa’s medical staff, facilities, and programmes would be state-owned and state-operated. the 7 million denizens currently subscribing to private sector healthcare would be reassigned to public sector healthcare (against their respective wills, but that’s another issue).

it is indisputable that private sector healthcare triumphs over that of the public sector, and the 7 million south africans presently subscribing to private sector healthcare receive a far superior quality of medical care than the 40 million utilising public sector healthcare. if this is the case, then why should south africa bring an end to private healthcare altogether? while it’s lamentable that optimal healthcare isn’t readily available to the entire south african populace, realistically speaking, it’s better that this higher standard of healthcare be available to at least some of the population, rather than none at all.

eliminating private sector healthcare in south africa altogether is a very dangerous concept. while decent healthcare is at least somewhat attainable in south africa, a complete transition to nationalised, public sector healthcare would eradicate any semblance of this. if private sector healthcare is allowed to remain, then it will eventually make its way throughout south african society – private firms, advertising a dramatically higher standard for healthcare, will entice consumers of all socioeconomic statues, and eventually the private sector will become the de facto option for medical services. if private sector healthcare ceases to exist in south africa, however, then there will be no chance of this, and the standard of living in this country will significantly suffer.

as the united states finds itself in the midst of this litigious issue in the context of its own population, it is important to remember that countries like south africa, despite a smaller population, have far less capital to spend on medical services as well. the discrepancy in healthcare amongst americans seems small in comparison to that amongst south africans. the existence of private healthcare, even in a minimal capacity, within south africa not only provides a greater quality of healthcare for denizens than would otherwise be possible, but also serves as a promise for a greater standard of medical care for all south africans in the future. by nationalising healthcare in its entirety and eliminating private sector healthcare, this possibility will be exterminated.