National Health Insurance, The Massive South Africa “Long Planned” Health Program


On August 2nd, South Africa proposes loan to the World Bank for the National Health Insurance, a seven years’ planned health program available for everyone. It’s aimed to improve overall health aspect of the country, community-wise and institution-wise. A healthy program for the nation, not so healthy for the government’s fiscal.

National Health Insurance (NHI) target, unlike other health programs, is not exhaustive. It is open for every south African citizen, from any socio-economic status.

Other than that, the program aimed the institution as well, hoping for a competition between public and private companies.

The question would be, how will the program be funded? And, will it be enough? What caused the “long planning”?

It would be the World Bank, hence the loan proposal pitched by the Delegation of South Africa this morning. That is only the first source, set at US $360 million.

The second one is the tax. There would be higher percentage allocated for the NHI from the general tax (set at US $100 million), thus all citizen obligated to pay tax would contribute to the funding of the program.

It’s expected that there would be imbalance demand between the private hospital and public hospital caused by the quality of respective hospital, ensuring competition between them.

Higher demand means higher money allocation for the claims. It also means higher public hospital improvement fund. All these, while the tax cut would be lower than the medical aid tariffs, even for the high-income groups, when otherwise they could afford the medical tariffs alone without the national health insurance.

The mentioned points may after all be the downsides of the NHI, that caused the years long delay, demanding a more comprehensive and detailed scheme.

Twenty years of payback period, for a loan as much as US $260 million. Are we waiting for the massive, successful improvement of the program? Or a deficit in government’s fiscal? We’re waiting for the final decision of the World Bank council, hoping for the best.