Health Protection

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The South African health system is characterised by both a large public and private sector. In 1994, the Government introduced the Free Primary Healthcare programme and has since built more than 700 clinics. The government provides free healthcare to pregnant mothers, people with disabilities, pensioners and the indigent. The impact of HIV/AIDS reversed many of the healthcare achievements, but now South Africa has the world’s biggest antiretroviral programme.

Yet, members of private medical schemes are generally ensured access to a medical care of higher quality, while the uninsured masses have access to inferior medical care. Private medical schemes provide cover for some 7 million people (14% of the population) and are characterized by excessive cost escalations and continuing affordability problems for low-income earners and retired people, while public-sector facilities provide care for some 40 million people on a means-tested basis.

Consequently, a national discussion over whether to introduce a comprehensive National Social Health Insurance is currently ongoing. The Reforms proposed so far seem to have three main objectives:

• adequate and equitable access for all citizens to minimum health care;
• macro-economic efficiency - the cost of health care should not exceed a reasonable proportion of a country's resources; and
• micro-economic efficiency - the range of services on offer should guarantee for a minimum cost, good results from a health perspective and ensure consumer satisfaction.

Regímenes de seguridad social y programas por rama