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Periodical article Periodical article Leiden University catalogue Leiden University catalogue WorldCat catalogue WorldCat
Title:Would Social Health Insurance Improve South African Health Care? What Other Middle Income Countries Can Teach Us
Author:Bachmann, Max
Year:1994
Periodical:Transformation: Critical Perspectives on Southern Africa
Issue:24
Pages:26-39
Language:English
Geographic term:South Africa
Subjects:health insurance
public health
Health and Nutrition
Politics and Government
External link:https://d.lib.msu.edu/tran/235/OBJ/download
Abstract:South Africa has poorer health indicators than other countries with similar per capita incomes. Distribution of health care is grossly unequal, whether one compares geographical areas, racial categories, or public and private sectors. The author argues that a well-managed public health insurance programme in South Africa could improve the efficiency of health care by, for example, promoting primary health care, and could improve equity by extending better health care to a greater proportion of the population. However, as universal insurance coverage is improbable given high unemployment rates, national health insurance (NHI) would probably have to begin with people in formal employment and their families, with the State continuing to provide services directly to the rest of the population. Thus publicly managed NHI is likely to involve the new South African government in formalizing inequality between the insured and uninsured, institutionalizing the social divide between the employed and unemployed. This paper looks at the experience with social health insurance of middle-income countries of Asia and Latin America, which have similar per capita incomes and similarly unequal income distributions. Bibliogr.
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