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A critical analysis of the suitability of a national health insurance scheme in South Africa
Author(s)
Mack, Zonique Lewore
Date Issued
2011
Type
Thesis
Publisher
Cape Peninsula University of Technology
Abstract
In South Africa’s two-tiered health system, some enjoy health care based on ability
to pay and others utilize services in an under-funded sector. The rift in the two, public
and private sectors, primarily exists because income categories either curb or allow
the necessary contributions. This thesis reports on the various contributing
mechanisms, through which health care can be ensured universally, without causing
impoverishment. The framework or criteria selected for this study includes feasibility,
equity, efficiency and sustainability of a contributing mechanism. Furthermore, the
contributing mechanisms – tax-funded, NHI, voluntary health insurance and out-ofpocket
– are resident within four health care models namely, Beveridge, Bismarck,
NHI and Out-of-pocket. These models are discussed as well as relevant country
examples are provided. In the pursuit of answering whether the NHI scheme is
suitable for South Africa, the study shows that government or tax-funding and NHI
provides the contributing mechanisms that are applicable to the South African
situation within the context of different challenges. It is recommended that, in the
government’s discussions about health care reform, prepayment, universalism and
health care expenditure, amongst others, be considered.
to pay and others utilize services in an under-funded sector. The rift in the two, public
and private sectors, primarily exists because income categories either curb or allow
the necessary contributions. This thesis reports on the various contributing
mechanisms, through which health care can be ensured universally, without causing
impoverishment. The framework or criteria selected for this study includes feasibility,
equity, efficiency and sustainability of a contributing mechanism. Furthermore, the
contributing mechanisms – tax-funded, NHI, voluntary health insurance and out-ofpocket
– are resident within four health care models namely, Beveridge, Bismarck,
NHI and Out-of-pocket. These models are discussed as well as relevant country
examples are provided. In the pursuit of answering whether the NHI scheme is
suitable for South Africa, the study shows that government or tax-funding and NHI
provides the contributing mechanisms that are applicable to the South African
situation within the context of different challenges. It is recommended that, in the
government’s discussions about health care reform, prepayment, universalism and
health care expenditure, amongst others, be considered.
Additional information
Thesis (MTech (Public Management)--Cape Peninsula University of Technology, 2011
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