Q and A with Health Minister Aaron Motsoaledi

Author: Chris Barron

Source: Sunday Times

In a National Health Insurance policy document released in July, Health Minister Aaron Motsoaledi says he wants to end medical aid tax credits. Chris Barron asked him.

As a source of funding for vulnerable people who are not on medical aid.

Wouldn’t it be better just to stop government looting?
This doesn’t exclude stopping looting. But you can’t say, “I’m not touching tax credits because there is government looting.”

How will it help the poor?
We are going to provide them with health services they don’t have now because they’re not on medical aid. The rich are being subsidised with tax credits.

Is it only the rich who have medical aid?
I’m classifying them as the rich. All of them who have medical aid are rich relative to the 84 percent who don’t.

Won’t this overburden public healthcare by forcing more people to use it?
No, it’s overburdened now.

But now you want to force even more people into it?
No. Who told you that?

They won’t be able to afford medical aid if you remove their tax credits, will they?
Why are you running away from the fact that there are vulnerable people who are not covered?

If you care so much about vulnerable people why is public healthcare so bad?
Because all the resources are used for only 16 percent of the population.

Not because of incompetence, mismanagement and corruption?
Resources follow money. The skills, the good managers, the technical experts, they all follow where the money is, which is in private healthcare. So, what do you expect?

Is the answer to make it impossible for people to access what decent healthcare there is by removing tax credits?
The funding of NHI I’ve left to Treasury. If they can fund it and say, “Minister, we don’t have to cut the tax credits,” I’ll say “yes” immediately. But I’m saying the 84 percent of the population without medical aid are also South Africans and they deserve to be served.

Which the government is not doing, would you agree?
No, that is very, very false.

Is the government providing them with access to decent healthcare?
The constitution says the state must do everything within its power to make sure that healthcare as a right is realised. NHI is part of doing that.

If you destroy the private sector, what will happen to healthcare professionals?
Nowhere have I said I want to destroy the private healthcare sector.

Won’t this happen if you stop people from using it?
Who said we are going to do that?

By making medical aid unaffordable?
I’m not making medical aid unaffordable. Medical aid has still got heavy subsidies.

But you want to remove them?
Tax credits are not subsidies. It’s an incentive, which is not serving its purpose.

Isn’t its purpose to relieve pressure on public healthcare?
And it has dismally failed. The pressure is even more, as the burden of disease increases, as more people are unemployed.