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The Democratic Alliance (DA) believes that we desperately need to improve the quality of care in our hospitals, so that all South Africans, particularly the poor, can rely on affordable care. But the cost of government's proposed National Health Insurance (NHI) scheme, which some estimates have put at upwards of R100-billion extra per year, has the potential to balloon our budget deficit without making any meaningful impact on state healthcare provisions.

Right now, officials involved in planning for the NHI have not provided publicly any financial modelling for this scheme. Indeed, it is unclear whether any financial modelling has taken place at all. At the same time, the NHI has come onto the policy agenda at a time of shrinking government revenues. Tax revenues for the 2008 financial year fell R16.9 billion below projections, and by May 2009, just two months into the current financial year, actual tax revenues had already slipped R6 billion below expectation. It is clear that the slowdown in economic growth is gathering momentum at a far steeper pace than expected and that tax revenues will be significantly lower than projected in 2009. This, then, is the worst possible time to be tinkering in untested schemes that may well balloon the budget deficit.

It remains unclear at this point how the NHI will be funded, exactly how much it will cost, and what its implications will be for government borrowing and the budget deficit. What is clear, however, is that it does not offer solutions to the urgent problems facing South African public healthcare. As long as ANC cadres are deployed to run state hospitals and bureaucracy continues to hamper hospital governance, little in the way of meaningful progress can be made in improving the standards of care. If anything, the NHI threatens to decimate the current capacity of the system and leave the poor worse off than they already are.

The Democratic Alliance has submitted parliamentary questions to the Minister of Finance to obtain the clarity that South Africans so urgently need. The DA believes that we do not need to spend billions more to improve the health system; instead, we need to get the basics right, by employing the right people with the right qualifications to manage our hospitals, by giving them the powers they need to do so, and by paying our doctors properly under the Occupation Specific Dispensation.