South Africa moves towards National Health Insurance

South African Health Minister Dr. Aaron Motsoaledi has publicly presented a National Health Insurance (NHI) white paper. The plan, already approved by South Africa’s cabinet ministers, aims to achieve health coverage for all South Africans. The establishment of the NHI Fund, financed by mandatory contributions from all citizens and permanent residents, means those in need will be able to purchase services from public and private health providers, guaranteeing access for all citizens and permanent residents without further payment. The plan will also set new limits on the services private medical insurers can provide.

South Africa is one of the upper-middle income countries, much like Brazil, which lacks a universal public health system and reform has been a major cause for activists. The policy announcement was described by South African newspaper The Daily Maverick as “the most radical health reform in South Africa’s history”.
– According to official government figures, a little over 16% of the South African population are covered by medical aid schemes, while 80% of the population is limited to public healthcare services.
– Although South Africa spends 8.5% of its GDP on healthcare, 4.1% of GDP is spent on 84% of the population. The remaining 4.4% is allocated to medical aid for the remaining 16% to be treated at private hospitals.
– South African academics Jane Doherty and Di McIntyre have suggested the South African health system is skewed in favour of patients who can afford private health care. Publicly funded services are often overstretched, forcing them to charge patients fees.
– The NHI is the most comprehensive plan put forward since the African National Congress (ANC) came to power in 1994. At that time, President Nelson Mandela launched free health services for pregnant women and children under six years old.
– The announcement of the NHI coincides with a row over President Jacob Zuma’s reshuffling of the finance minister twice in less than a week. The Zuma administration is under fire from critics over the state of the economy.
SA News, a government media agency, reports on the approval of the white paper.

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