The proposed National Health Insurance (NHI) scheme is without doubt a great concept and could be made to work in a country with a buoyant economy and a compliant, well-educated population that is used to the concept of accountability.

SA, however much we love our country, has none of the above. Indeed, it has a record of bureaucratic incompetence, leading to the failure of all state-owned enterprises. Why should the NHI be any different?

The overall economy and administrative ability of SA is in decline, together with its ability to generate the funding needed to drive an undertaking of this magnitude, resulting in the probability of the scheme foundering before it has really got off the ground.

Meanwhile, in its efforts to implement the scheme, the government will have disaffected the existing medical fraternity across the board, to the extent that a significant number of doctors and nurses and medical-aid experts will move elsewhere to pursue their careers.

This will leave a void in the health-care industry that will be very difficult, if not impossible, to fill in the years ahead.

George Johnstone