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58 Fighting the Diseases of PovertyPoliticisation of health careAs the government health sector is under political control, the viewsof key government officials on a particular medical issue directlyaffect the manner in which the government health sector deals withit. The views of the South African President and Minister of Healthon HIV/Aids are considered to have been the main reason 12 for thecountry’s slow response in dealing with the HIV/Aids problemdespite the government’s commitment 13 to decreasing the incidenceof infection.In a government planned and controlled health system, patientsare at the mercy of politicians and those appointed by them tocontrol the system.The “free health care” mythGovernment health policy entitles certain categories of patients,including pregnant women and children younger than six years ofage, to receive “free” general care, while “free” primary health careis available to every citizen (Health Systems Trust, 2004). However,the health care is not free. It is provided to patients at the expenseof the taxpayer.The day after Nelson Mandela, during his presidency, announcedthat “all pregnant women and children under the age of 6 years”would be entitled to “free” health care; some public hospitals couldnot cope with the large number of women and children who arrivedon their doorstep seeking medical care. The event dramaticallydemonstrated that if the cost is reduced, especially if it is reducedto zero, the demand increases exponentially. To cope with thisdemand, government health-care providers have no option but toreduce availability or deny health care to patients.However, the difficulties that arise as a result of the introductionof so-called “free” care are not limited to rationing – it also meansless efficient and more expensive health care (Reisman, 1996). Alarge bureaucracy is needed to administer a socialised healthsystem, which together with the built-in bureaucratic inefficiencies,add even more to the costs of so-called “free” health care. To control