The Law and Policy of Healthcare Financing
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The Law and Policy of Healthcare Financing

An International Comparison of Models and Outcomes

Edited by Wolf Sauter, Jos Boertjens, Johan van Manen and Misja Mikkers

Examining the ways and extent to which systemic factors affect health outcomes with regard to quality, affordability and access to curative healthcare, this explorative book compares tax-funded Beveridge systems and insurance-based Bismarck systems. Containing contributions from national experts, The Law and Policy of Healthcare Financing charts and compares the merits of healthcare systems throughout 11 countries, from the UK to Colombia.
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Chapter 17: Country report: South Africa

Alex van den Heever


The South African public health system is universally free at point-of-service for the entire population except for access to the hospital system, which is subject to a means test. Apart from significant regional differences, healthcare is marked by a division into public and private health insurance, the latter used by 15.6 per cent of the population. Doctors working in public hospitals are virtually all state employed, those working in private hospitals work are usually self-employed. Public hospitals are reimbursed on the basis of annual budgets, private hospitals are largely funded by fee-for-service payments. Proposals by the Competition Authority to address the private sector’s high levels of concentration have been developed, yet implementation is uncertain. Leaving aside the intrusion of racial segregation into South Africa's public policy, different population groups are increasingly being catered for and currently have a high degree of access to healthcare.

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