National Health Insurance
Public-Private Mix of Healthcare Coverage
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This is the second in a series of policy briefs on National Health Insurance (NHI). Their purpose and the related IMSA web-site is to put in the public domain material and evidence that will progress the technical work of developing a National Health Insurance system in South Africa. This includes tools for costing NHI and evidence on where savings could be achieved in moving to a future mandatory system with universal coverage.
This policy brief builds on the importance of working by age and gender to consider the demographic characteristics at various stages of a phased introduction of NHI. The relative impact on the price of healthcare is shown and effects are explored by province.
The graph below summarises the existing coverage for healthcare in South Africa and shows estimates of the expenditure per person, from work by Prof Di McIntyre and Alex van den Heever 1. The graph shows a more complex picture than simply a public-private split, with some 20.9% of the population using public hospitals but private primary care. This is funded out-of-pocket and a proportion of this group may be able to afford but have chosen not to join any medical scheme.
 Figure 1: Coverage for Healthcare in South Africa in 2005 1
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