Slow progress for universal healthcare in South Africa

The National Health Insurance (NHI), aimed at introducing affordable healthcare for all South Africans, will be implemented.

The National Health Insurance (NHI), aimed at introducing affordable healthcare for all South Africans, will be implemented whether there is opposition to it or not.

Dr Aaron Motsoaledi, Minister of Health: “Government has a constitutional responsibility to provide affordable healthcare to all citizens, irrespective of their economic status. The World Health Organisation recommends that countries spend 5% of its gross domestic product on healthcare, and in a disproportionate manner. The private sector spends 4.4% of GDP on health but only provides care to 16% of the population. The public sector spends 4.1% of GDP on health but has to provide care to 84% of the population. So this current financing system is unjust and needs to be reorganised so we can pool public and private sector funds to provide quality and affordable healthcare to all South Africans.”

The Competition Commission enquiry to ascertain whether there are unfair market practices in private healthcare will be completed by the end of the year.

Motsoaledi: “This is socio-economic transformation. You can also call it radical economic transformation, because the whole aim of NHI and checking the price of private healthcare is not only about health – it’s about who gets what. We are resolute that we must create a National Health Insurance system in our country, and that we should have improved access to quality healthcare by ensuring that, as a nation, we contribute towards providing this quality healthcare. So the private sector has the option of becoming a part of the NHI, which happens in other domains that they offer particular services – because it is a package of services that will be available.”

Africa Check is Africa’s first independent fact-checking organisation. Does South Africa’s private healthcare sector only serve 16% of the population?

  • The 2015/2016 annual report of the Council for Medical Schemes notes that only 16% of the South African population belong to medical schemes while the rest of the population depends on an overburdened government sector.
  • Statistics South Africa’s 2016 General Household Survey estimates that 17.4% of the population had medical aid. But the number of people with medical aid does not equal the number of people using the private healthcare sector.
  • In 2016, Statistics South Africa estimated that 1,515,000 households with no medical aid normally used the private healthcare sector and 706,000 households where at least one member had medical aid used the public health sector.
  • Under this assumption – that is influenced by the household member’s age, sex and particular illness or injury, 13,393,357 South Africans (24.3% of the population) normally used private healthcare in 2016.
  • Depending on their health needs, many people use a combination of private and public healthcare services. Shares vary, depending on how the surveys are carried out and the question asked.
  • While it is true that the majority of South Africans do not benefit from private healthcare, it is misleading to equate medical scheme coverage – or the lack thereof – with the exclusive use of a particular healthcare sector.

Whether the private sector becomes part of NHI or not will determine if it has spare capacity for medical tourists.