Abstract
M.Com. (Business Management)
It is a well established fact that the majority of South Africans
do not have access to health of a satisfactory quality, and that
many have almost no effective access to health care at all.
Health care in South Africa today can be characterised as being
both inequitable and inefficient. It is inequitable as
particular groups enjoy privileged access to health care, whereas
others do not have any access at all and it is inefficient
because of the existence of over treatment in the private sector
and fragmentation in the public sector (Picard, 1992:1).
In 1987, according to the best calculations available, South
Africa spent R9,2 billion on health care. This figure amounted
to 5,8 percent of the Gross National Product (GNP) for that year
(De Beer & Broornberg, 1990:1). The private sector accounted for
44 percent of expenditure that year, yet supplied health care to
20 percent of the South African population. On the other hand,
the remaining 80 percent of the population had to rely on the
public sector where just 56 percent of the total expenditure was
located (De Beer & Broornberg, 1990:1).
It is clear that the pUblic sector is unable to provide adequate
health care for 80 percent of the population on the money
presently available. This inability to provide services in the
public sector has arisen from fragmentation and duplication of
facilities, excessively bureaucratic management structures, undue
emphasis on expensive curative care, high technology tests and
interventions at the expense of providing basic health services.
In addition to this, the public sector has been significantly
underfunded. This can be supported by the above figures that
show that 3,3 percent of the GNP is spent on public sector health
care and this figure is well below the 5 percent target set by
the World Health Organisation as a minimum standard ,(De Beer &
Broomberg, 1990:1).