Abstract
M.A. (Public Management and Governance)
The study deals with the nature and problems of the proposed National Health Insurance system in South Africa in order to develop a management and governance model to promote universal healthcare in South Africa.
The general aim of the study is, therefore, to analyse the concepts and policy initiatives related to the resolution on the National Health Insurance (NHI) scheme being passed at the ANC’s 52nd National Conference in Polokwane in 2009. Calls for a NHI together with relevant legislation and programmes, have consistently formed an integral part of Government’s national effort to build a united national health system in which the public health sector plays a dominant role as provider of first choice. The proposed NHI is a state-mandated and state-administered health insurance scheme that provides universal and comprehensive cover to all South Africans in spite of their financial status. In essence therefore, the vision of the NHI system is to be inclusive of the unemployed and the indigent who will also be afforded the opportunity to receive healthcare which is on par with everyone else’s and not based on what they can or cannot afford.
This enquiry is premised on the variables that have influenced the development of South Africa’s healthcare system, the implementation challenges of the proposed NHI, according to the National Health Insurance Policy Paper of 2011, and the lessons that South Africa can derive from the implementation of the national health insurance schemes of Brazil and Ghana.
The dissertation concludes that there are certain challenges in the current NHI debate in terms of the lack of technical details on the proposed NHI system, a lack of transparency in terms of the process, as well as problems related to the exclusion of the main stakeholders in the public and private health sector.