Contents
1 INTRODUCTION ........................................................................................................................ 4
2.
PROBLEM STATEMENT ........................................................................................................... 5
2.1
THE BURDEN OF DISEASE
IN
SOUTH AFRICA ..........................................................
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2.1
.1
H V/AIDS and
TB
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2.1.2 Maternal, Child and Infant Mortality .......................................................
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8 .
N
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-:0-JYii:_>
2.1.
3 on-Commumcable
D1seases
.............................................................. ·""''•''' ................. 8
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2.
1
4
I n)ury and Violence ......................................................................
y
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8
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'•/•.
2.2 QUALITY OF HEAL THCARE .........................................................
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>
2.3 HEAL THCARE EXPENDITURE
IN
SOUTH AFRICA ............
.....
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il\lli!!!:
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9
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2.4 DISTRIBUTION OF FINANCIAL AND HUMAN
.................................
10
2.5 MEDICAL SCHEMES INDUSTRY ..........................
:
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O:l,,11:ti.Yi
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11
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3.
HISTORY OF PROPOSALS
ON
HEALTHCARE FINANCiNG REFORM
IN
SOUTHAFRICA ..............................................................
1
..
3.1
Commission on Old Age Pension and
(1928) .....................................
12
3.2 Committee of Enquiry into
(1935) .............................................
12
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q,;_,
3.3 National Health Service Com!)i!j$8{
'·
-1944) ...........................................................
13
z.<t••·
,,,
3.4 Health Care Finance
1994 ...............................................................................
13
3.5 Committee
of
Inquiry
Insurance (1995) ................................................
14
3.6 The Social Health
Group (1997) ...........................................................
14
--
w'«it
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3.7 Committee
Comprehensive Social Security for South Africa (2002) ......
14
3.9 Advisory Committ'l;le
on
National Health Insurance (2009) .................................................
15
/·-,<-----
"<iiRvd:F··
4.
NATIONAL HEAl:"''H INSURANCE ........................................................................................
15
41'JJ;;\
...
i
5.
OF NATIONAL HEALTH INSURANCE
IN
SOUTH AFRICA ........................
16
--·-
\Yhc
·-··;:
6.
OF NATIONAL HEALTH INSURANCE ..........................................................
18
,-1/;;-.>
\/.,
/''.-<·
\'•27Ji$0CIOECONOMIC BENEFITS OF NATIONAL HEALTH INSURANCE .............................
19
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•
Economic Impact Modelling .............................................................................................
21
8.
THE THREE DIMENSIONS OF UNIVERSAL COVERAGE .................................................
21
9.
POPULATION COVERAGE UNDER NATIONAL HEALTH INSURANCE ..........................
23
10.
THE RE-ENGINEERED PRIMARY HEALTH CARE SYSTEM ..........................................
23
1
0.1
District Clinical Specialist Support Teams ..........................................................................
24
2