New findings contradict NHI White Paper

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Recent research conducted by Econex, a leading firm in competition economics, paints a different picture to that portrayed in the NHI White Paper on healthcare in South Africa.

In a research note published this month, it challenges the claim that the current financing system punishes the poor.

A summary of the research, published as a blog post, positions its research:

“A central issue in driving universal cover under a National Health Insurance (NHI) system is the redistribution of resources to the poor, whose need for healthcare generally exceeds the resources allocated. This is an important issue, as it is recognised that healthcare resources need to be distributed in an equitable manner. However, the South African debate has been polarised on this issue with claims that the South Africa has a “financing system that punishes the poor” (stated in both the 2015 and 2017 versions of the NHI White Paper).”

“In order to contribute to the ongoing debate and in the light of renewed focus on the implementation of (NHI) in South Africa by 2025/2026, Econex has updated the research on the socioeconomic distribution of healthcare benefit and healthcare financing, This research has been commissioned by Mediclinic South Africa. In updating the research on this issue we have relied on household survey data, information from the Council for Medical Schemes, as well as estimates from National Treasury.”

“We find that financing incidence is in fact pro-poor in the sense that the wealthiest 40% of the population contributes the largest share. The poorest 60% of the population receives a higher proportion of benefits than what they pay for – a distribution that is in line with principles of equity and social solidarity. However, it must be noted that this poorer part of the population receives fewer benefits than those received by the wealthier 40% of the population. Importantly, the poor receive a smaller proportion of total healthcare benefits than what their share of healthcare need warrants. This is problematic.”

The more comprehensive (9 page) Econex research Note 45 can be downloaded here.