What about healthcare?- by Mica La Vita

Of late, I have been reflecting about what the next 10 years of my life will look like. This process has led me to ask serious questions about my activism, career, and my current job. It’s motived me to start looking for opportunities to work with organizations that pursue similar values to my own. Values such as equality, dignity, justice, community, and environmentalism. One such organization that I came across is the People’s Health Movement.

The name alone tells me that they position themselves as an entity that unites people and awakens consciousness, and this around a particularly contentious issue in South Africa – healthcare.

 

Healthcare in South Africa is a topic that I’m sure so many of us have lamented over. The expense, the service one receives and the accessibility both of facilities and in the power relations between clients and practitioners. And as I made the decision to use the term clients it reveals the capital-oriented, transactionary relationship that exists between people and healthcare services in the biomedical industry (thinking through the variety of available alternative health and wellness practices needs another blog post).

 

Just the other day I was in a discussion with a good friend who suffers from a chronic illness that affects her ability to do what many of us consider the most menial of tasks. She was dejected because she was unable to afford going to her specialist doctor, to help manage her condition. She is a middle-class woman with access to a number of luxuries (in the South African context) such as decent housing and a car, but the expense of seeing a private specialist medical doctor is often out of reach for her. My own grandfather, who is elderly and beginning to experience health issues, also faces concerns of affordability in accessing healthcare as he lives off a state pension. My friend and I got to talking about how much more removed working class and poor people,

My own grandfather, who is elderly and beginning to experience health issues, also faces concerns of affordability in accessing healthcare as he lives off a state pension. My friend and I got to talking about how much more removed working class and poor people, suffering with the same chronic condition as her, are from getting medical attention and what that means to their daily lives. It would mean that without the necessary therapy and medication programme they could not function in the workplace – that’s if they even get so far as being correctly diagnosed. In our everyday general wellness needs, such as being born, growing, reproducing and aging, to serious illnesses such as cancer, diabetes and HIV/AIDS access to quality medical services is of vital importance to everyone.

 

In a recent article in the Daily Maverick Louis Reynolds, a retired paediatrician and a member of the People’s Health Movement (PHM), questions the relationship between healthcare as a universal right, the state as the primary service provider and capital interests and influence from corporate enterprises. How do these three relate and what does that mean for people living in South Africa that need to access healthcare services? Reynolds highlights for us, the public, that we need to be mindful, critical and engaged in shaping the policies our government produces and implements which will determine how healthcare is made accessible in a democratic state that seeks to transform the inequalities of our brutal past.

How do these three relate and what does that mean for people living in South Africa that need to access healthcare services? Reynolds highlights for us, the public, that we need to be mindful, critical and engaged in shaping the policies our government produces and implements which will determine how healthcare is made accessible in a democratic state that seeks to transform the inequalities of our brutal past.

Reynolds highlights for us, the public, that we need to be mindful, critical and engaged in shaping the policies our government produces and implements which will determine how healthcare is made accessible in a democratic state that seeks to transform the inequalities of our brutal past.

 

A rights-based approach to healthcare is a well-established discourse. And as an avid viewer of the Daily Show with Trevor Noah and the Late Show with Stephen Colbert, I wonder how even the USA – rampant free-market capitalists that they are – could institute Obamacare (albeit under threat in the Trump administration) while we are still trying to figure out if quality universal healthcare is actually an urgent priority. Don’t get me wrong, I am aware that over the past 20 years massive strides have been made in improving public medical facilities and services in apartheid-produced  economically marginalised areas, but if apartheid-era benchmarks are the median we measure ourselves against we have a massive problem of consciousness. I just cannot accept that class distinction, through whichever mechanisms be it race, gender, age, nationality, ethnicity, economic standing, geographical situation, etc. is considered as a rational or inevitable barrier to equal access for essential shared services, in particular education and healthcare. What does it say about our humanity (our conscience and consciousness) if we are ok with other people and other people’s children being locked out of services and systems that validate their well-being and dignity? Civil society movements and

I just cannot accept that class distinction, through whichever mechanisms be it race, gender, age, nationality, ethnicity, economic standing, geographical situation, etc. is considered as a rational or inevitable barrier to equal access for essential shared services, in particular education and healthcare. What does it say about our humanity (our conscience and consciousness) if we are ok with other people and other people’s children being locked out of services and systems that validate their well-being and dignity? Civil society movements and

What does it say about our humanity (our conscience and consciousness) if we are ok with other people and other people’s children being locked out of services and systems that validate their well-being and dignity? Civil society movements and

Civil society movements and organizations such as PHM, Equal Education, Reclaim the City, AVAAZ and a number of others, provide us with platforms to direct our civic energies to impact social processes we are passionate about. Social media has made it easy for us to stay informed and get involved. Empowerment starts with movement, with action and healthcare reform in SA is perhaps one of the most important current issues for us to speak up about.

 

Widespread inequality is an engineered system.

That means it isn’t incidental, it didn’t just happen – it was constructed, cared for, maintained and accepted.

We understand our history and how this inequality came to be, but I don’t think that means we should sit back and accept it. In the current democratic system, the state represents us. The state answers to us, well theoretically speaking. Civil society has power through local government, mass action, interest groups, NGOs and lobbying. Through these instruments, the people and the government shape public goods.

A particular concern that Reynolds highlighted in his op-ed was the make-up of stakeholders now responsible for developing policy for the proposed National Health Insurance scheme (NHI). Private business and elite interest groups appear to hold the majority of roles. The purpose of the NHI is to set in place structures for a sustainable, state sponsored and managed universal (access for all) healthcare system in South Africa. The conceptualisation and implementation of the NHI is a critically important institution in our democracy that requires engaged citizenship through a variety of platforms. Since healthcare impacts everyone, throughout the course of our lives, this is an opportunity for us to become involved in shaping our society that will affect generations to come.

 

Those who know me will sometimes describe me as anti-capitalist, pro-egalitarian and most definitely feminist (that’s why I can’t go work in the UAE and earn fortunes!) I approach profit-making institutions with a healthy dose of skepticism.

I’m not totally against profit, I enjoy many of its benefits, but I am against the primacy of profit particularly around human rights services.

Movies like War Dogs depict the crass nature of profit literally at the cost of human lives (and animals and the environment). Big business has a place in a transformative society like South Africa, aside from maintaining economic stability and driving growth. Money and networks of powerful people and groups have enormous capacity for driving, or supporting, social change. Working in the public benefit space has put me in a position to work with companies that truly seek to positively impact the building of an equitable society. However, we have seen over the past few years (well decades really, even centuries if we go back to the VOC) how corporations and oligarchs can cripple entire countries, societies and geographic spaces in the pursuit of capital and profit. They can and do at times work against human rights. Jay Naidoo advises that the balance to capital domination, in a profit-oriented world, is community building. Community building includes working with captains (and sometimes pirates) of industry. If we consider ourselves living in a social ecosystem, it becomes clearer that numerous communities and interest groups must work together in order for everyone to survive. In shaping our health and wellness services, there is a need for citizens, businesses, NGOs and politicians to collaborate. Citizens – you and me – perhaps most importantly, must be the conscience and the police to ensure that the best greater good approach is followed.

Jay Naidoo advises that the balance to capital domination, in a profit-oriented world, is community building. Community building includes working with captains (and sometimes pirates) of industry. If we consider ourselves living in a social ecosystem, it becomes clearer that numerous communities and interest groups must work together in order for everyone to survive. In shaping our health and wellness services, there is a need for citizens, businesses, NGOs and politicians to collaborate. Citizens – you and me – perhaps most importantly, must be the conscience and the police to ensure that the best greater good approach is followed.

 

I suppose, what this rather long blog is getting at, is that we are at a very important moment in history and us regular folk can impact it by being informed, engaged and moved to action. Even if you can currently afford private medical aid or insurance, many people you know probably can’t. The development of the NHI brings our connectedness to the forefront, where we can think through what kind of society we are building for now and the future.

 

Interesting reading

If you’ve come to the end of this blog, you must love reading! To learn more about the NHI, health activism in SA and the right to health as a global concept I have some links for further reading (like Alice down the rabbit hole).

Check out Louis Reynolds article on the PHM website and while you’re there have a look around at their projects http://phm-sa.org/op-ed-has-the-national-health-insurance-process-been-captured/

Brand South Africa has a good summary of healthcare in SA https://www.brandsouthafrica.com/south-africa-fast-facts/health-facts/health-care-in-south-africa

And where would we be without Wikipedia https://en.wikipedia.org/wiki/Right_to_health

Mica

Mica La Vita

 

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