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Durban - The gross disparity between the public and private health sectors is unjust and unethical.

The was the harsh diagnosis presented by Professor Hoosen (Jerry) Coovadia, emeritus professor of paediatrics and child health, to the Discovery Volunteer Forum in uMhlanga.

Coovadia is a commissioner at the National Planning Commission, working on the National Development Plan’s focus on health. It aims to improve the health sector by 2030.

Having worked in the public health sector for his entire professional life, as well as contributing to numerous medical journals and publications, Coovadia was selected to contribute towards discussions and research on the proposed National Health Insurance plan.

“South Africa is the most unequal country in the world,” Hoosen said last week.

“It’s immoral that people must pay for education and health. When you go see a doctor, the first thing they ask you is, ‘Do you have medical aid?’ It’s no money, no service.”

Although there had been improvements in the health sector in the past 19 years, such as a decline in the infant mortality rate, the growing divide between public and private health, as well as the escalating costs of private health, was unsustainable, he said.

Citing an article published in The Lancet last year, Coovadia said that 44 percent of private health care funding went to helping only 16 percent of the population, whereas 43 percent of public health care funding went to helping 68 percent of the population.

The remainder was out-of-pocket payments.

Coovadia said that another problem was the movement of specialised doctors and equipment to the private sector.

“Years ago, the specialists would be in the public sector. If you needed any specialist surgery, that’s where you would go. That’s not happening any more,” he said. “We need to build up our specialists and not allow the private sector to blackmail us by saying if their salaries are cut, they will emigrate.”

The government’s green paper on National Health Insurance states that South Africa spends 8.5 percent of its GDP on health care services, 2.5 percent more than recommended by the World Health Organisation, yet the health outcomes are still poor.

It also indicates that private health-care costs have increased by 121 percent in the past decade, which means “the private health-care sector will have to accept that the charging of exorbitant fees completely out of proportion to the services provided has to be radically transformed”.

In the private sector, annual expenditure per capita is R11 150, compared with R2 766 in the public health sector.

“Health and education are essential to building a better… society. This will improve our capability,” said Coovadia.

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