The state can barely hold it together. The power utility, Eskom, is on the verge of collapse. Last week it told bondholders at a roadshow in London that it wants the majority of its R441bn debt transferred to the SA government. Read that again: R441bn in debt. In the same week Eskom announced an annual loss of R20.7bn.
Just a month ago finance minister Tito Mboweni announced that Eskom and SAA are among the state-owned enterprises that will receive support from the country’s contingency reserve account.
The SABC and weapons maker Denel — both perennial money burners — are on that list too.
An exasperated Mboweni said: "I must emphasise that this additional government support cannot be a blank cheque for these state-owned enterprises. We really and truly cannot go on like this."
In the midst of the economic crisis we are going through, a genius in the ruling party and government decided that this was a good old time to publish the draft National Health Insurance (NHI) Bill.
At least one government official quoted by Reuters estimated that universal health care for millions of poorer citizens would cost about R256bn to implement by 2022.
Stop and use your fingers to count that again: R256bn.
So here you have a government that cannot run a power utility, or an arms manufacturer, an airline or pretty much anything else it touches, telling you that it’s going to force you to ditch your private health-care provider and go to Jubilee Hospital in Hammanskraal or Chris Hani Baragwanath in Soweto.
Both are heaving with exhausted doctors, too many patients and a plethora of other problems. Anyone who actually believes that an ANC government can be entrusted with running a sophisticated, well-executed universal health-care system needs their head examined — at a private facility, because the state psychiatric system has virtually collapsed.
That’s the problem, really. We take on these huge, ambitious projects without dipping our finger into fixing the small stuff. When many government hospitals cannot get the lifts to work or sort out a laundry system, how exactly are the same people going to run an NHI system?
We can’t run land claims courts — we give them virtually no judges. The entire land restitution process is a hotbed of corruption and incompetence. Yet we tell investors a national scheme for land expropriation without compensation will run smoothly.
Who are we fooling here? We are cutting corners. We haven’t done the hard work at a micro level of preparing ourselves for the tougher macro tasks. Then we act surprised when the market punishes us.
History does not teach us anything. We introduce legislation and all sorts of schemes with nothing but hope. Then we fail spectacularly.
Instead of targeting private health care, make that which is meant to serve the poor work
Who doesn’t want an NHI scheme? Believe me, I lived in the UK for two years and everyone loved their National Health Service. It is the most transformative and democratic public policy initiative I have seen anywhere in the world. It is a triumph, an example of what a humane society is truly about. SA needs it.
Yet we fool ourselves that we can afford it (we can’t) or that we can implement it (again, we can’t).
Just ask those public service workers who trashed Tshwane two weeks ago whether they are willing and able to provide a real service for the people. They will strike within seconds.
This is why we fail. We are not short of great, useful and necessary ideas. The problem is implementation. We suck at it. We are so bad at implementation that a serial lawbreaker like former mineral resources minister Mosebenzi Zwane is not behind bars. If we cannot achieve that, we are in trouble. Very big trouble.
We need to fix the nuts and bolts.
Fix Eskom and electricity supply. Fix Denel or sell it. Fix SAA. Fix Baragwanath. Fix the collapsed health system in the rural Eastern Cape. Instead of balefully targeting the private health-care system, make that which is meant to serve the poor actually work. Show your seriousness by being single-minded about fixing the basics.
Right now we are on the road to ruin by failing to prepare.
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