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The Future of Health Care in South Africa 


One of South Africa’s biggest challenges is to provide its people with an effective healthcare system that provides quality care to the sick in future. The whole idea is to ensure that everyone has fair opportunities to benefit from good healthcare. 


The National Health Services isn’t a new idea and in fact, it dates back to 1944 when the Gluckman Commission put forward the National Health Services that would be funded through the use of taxpayer’s money.  


It didn’t garner much interest as it was felt that it would put extra burden in future on the middle-income group which was already strained.  

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During the 1980s and 1990s however, the question as to whether South Africa could afford to fund the national health insurance program re-emerged. 


The question of funding the future


The worrying thing about the NHI and South Africa is that if the country were to be able to afford funding its NHI program, it would require growth in excess of 5% per annum in future.  


If it can’t grow the economy, the shortfall in funding would be too big, requiring the government to borrow from other countries. Not being able to pay back its debt would simply increase the likelihood of the country being downgraded and no longer seen as a destination for investment. 


There have been talks that the tax base should be used to fund NHIin future People suggest that If the current tax rebate of private medical aid members is removed, funding could be raised for NHI but this would affect those who rely on this rebate.  

South Africa spends R450 billion on private and public healthcare, supporting 80% of the population.  


It has been worked out that NHI will cost R256 billion but nobody seems to know how funding will take place. When you consider the low GDP, unemployment, socio-economic status and crime within the government, you can’t just willy nilly adopt a universal healthcare system that has been successful in other countries.  

NHI doesn’t cover everything

One has also got to bear in mind that NHI isn’t going to be equal to having a comprehensive medical aid. In fact, because of this, there should be room for existing private healthcare for medical services not included in the NHI.  

In the healthcare system, there are a lot of stakeholders, and both the private- and public healthcare sectors need to be involved so as to address all the challenges that South Africa has.  

If there are certain elements that are failing, they need to be identified and fixed.  

Leaders to lead the way with healthier lifestyle? 

It is important that a national healthcare system is led by example and education. Lifestyle diseases such as obesity, high blood pressure and diabetes is just another kind of pandemic in South Africa.  

Primary healthcare will need to educate the population on how to prevent these diseases from developing in the first place. Doing this will reduce healthcare expenditure on treating these diseases that develop from an unhealthy lifestyle.  

South Africans want to see slimmer, healthier examples of this lifestyle from its very own leaders in government otherwise it is just a case of empty vessels make the most noise. 

IS the NHI viable for South Africa? 

The question remains – is the NHI viable for South Africa?  To look at NHI, one has to reflect on the Covid-19 pandemic. We can be optimistic about the way the pandemic has been dealt with, showing that there are indeed areas of excellence in the public healthcare sector.  

Lee Callakoppen, Principal Officer of Bonitas Medical Fund,  believes that it simply has to work and that universal healthcare is a right, not a privilege.  

Certainly, we need strong leadership and accountability in future so that South Africa isn’t constantly dealing with investigations into people who use their positions in government to siphon funds intended for healthcare.  









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