ROB ROSE: Cosatu’s NHI blindness

It is sobering to reflect on why so many trade unions are flirting with irrelevance.

On this score, the antics of the country’s largest labour federation Cosatu, which picketed outside the Constitutional Court this week against a challenge to National Health Insurance (NHI), are deeply illuminating.

On Tuesday, the first of 15 legal challenges to NHI kicked off in that court, with the Board of Healthcare Funders (BHF), which represents 40 medical aids, arguing that this landmark health-care policy was passed without any meaningful public participation.

“We kept saying: ‘But the emperor has no clothes.’ Everybody can see that the emperor has no clothes, and yet [lawmakers] still go ahead and enact legislation that says the emperor does have clothes,” BHF counsel Bruce Leech argued in court.

While NHI has been falsely sold to the public as a panacea for poor-quality state health care, it is far from that. But this court case centred largely on procedure, with Leech arguing that parliament ignored the three main public concerns outlined in 340,000 submissions before rubber-stamping the bill.

“First, how much is this going to cost — can we afford it, in other words? Secondly, what am I going to be getting in return? And thirdly, how will this work, especially because [government’s] track record suggests a lack of trustworthiness?” he argued.

Those are not nice-to-knows, Leech said, but “integral questions” since the public will have to pay for NHI through new taxes.

The Constitutional Court must now decide if the public participation process was so flawed that the law must be set aside, and the process begin from scratch.

The stakes are high, since this legislation will effectively eradicate private medical aids, creating a single state-run NHI fund all doctors will have to contract into, and from which all medical services will then be distributed.

Intuitively, you’d think this would be bad news for the country’s workforce.

Not only will NHI dilute any medical benefits they get from their employer, but it will also slash their take-home pay, as new income taxes will be needed to pay for the policy. (Many analysts project a funding shortfall exceeding R400bn a year.)

It is no wonder the general public views trade unions as self-serving, with some of their members having their hands in the cookie jar

—  Mbhazima Shilowa

And yet, quixotically, there was Cosatu this week, picketing outside the Constitutional Court in defence of NHI.

Cosatu spokesperson Zanele Sabela said NHI is the only way to put an end to “the two unequal systems currently in place, which are remnants of apartheid — one for people with money and another for the poor and working class”.

But despite the manifest lack of detail over funding, Sabela claimed there had been “incredibly extensive” public consultation.

Now, how can this be good for Cosatu’s members, you wonder?

“The simple answer is that it isn’t — I don’t understand how any union could be in favour of the policy,” says Theuns du Buisson, a researcher at Solidarity, another trade union which, in contrast to Cosatu, has gone to court to demand that NHI be scrapped.

“The trade unions I’ve spoken to which do support NHI argue that it’s a step towards equality, but it really isn’t,” Du Buisson says. “Our research shows it’ll require a minimum of an extra 14% payroll tax on everyone, while those people who get medical aid from their employers will be drastically worse off.”

Du Buisson says 90% of the doctors and therapists who make up Solidarity’s members say they will close their practices, retire early or leave the country if NHI is imposed.

And yet, there is one potential answer to why Cosatu is supporting the government’s political ambitions, an answer which might also explain why it has lost a good chunk of its membership in recent years.

In a word: politics. Cosatu may be weaker than two decades ago, but it still remains an alliance partner of the ANC, which has made NHI a signature policy. To protect its political partner, it is forced to shield NHI.

Now, it is true that trade unions played a pivotal role in thwarting apartheid, which explains why they were so powerful when the country entered democracy.

But that was 32 years ago. Today, there are an estimated 3.1-million union members in South Africa, sharply lower than the 4-million of a few years back. And Cosatu, which boasted nearly 2.2-million members in 2012, has dribbled down to 1.8-million.

Former Cosatu general secretary Zwelinzima Vavi told the Sunday World this week that much of this decline is because unions lost their edge. “When leaders no longer experience what workers go through — the daily struggle, the transport, the long hours — that disconnect grows.”

There are, of course, other factors in this decline. Besides a disconnect from members, an economy that grew at less than 1% a year for a decade didn’t help. But the frequent inability of many unions to think in any commercial way only made it worse.

Mbhazima Shilowa, also a former Cosatu leader, wrote recently of the “wilful blindness” of some unions, pointing out how, as much as they railed against corruption, they also looked the other way when their own members were nabbed.

“It is no wonder the general public views trade unions as self-serving, with some of their members having their hands in the cookie jar,” he wrote in News24.

Now, you can understand that in the case of NHI, some unions will have just bought the ANC rhetoric wholesale, without delving deeper into the impact on salaries or benefits. But this intellectual laziness buttressed their political aims too. This NHI case illustrates the Achilles heel of the fastest-shrinking unions: in shifting their emphasis from protecting workers to protecting their own political alliances, they’ll only hasten their slide into irrelevance.