Abstract
The establishment of the National Health Insurance (NHI) provides the
South African Government with an alternative means to restructure
South Africa’s failing healthcare system. Calls for a NHI with the
National Health Insurance Policy Paper of 2011, 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
fi rst choice. The article provides an overview of health care pre-1994,
post-1994 and then focuses on the challenges confronting the South
African health care system. The article concludes that apart from 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, the most crucial
areas of contention in this regard is the shortage of health care workers
within the South African health care system. South Africa is struggling
to meet its pledge for health care for all as a result of increasing staff
shortages in public sector healthcare.