01 - South African Healthcare Environment Flashcards
What are the forces driving change?
A strong political agenda
An economic agenda
A vibrant consumer agenda
Socio-demographic demands
Bio- and medical technology innovation
What is the vision of the National Department of Health?
A long and healthy life for all South Africans
What is the mission of the National Department of Health?
To improve health status through
- the prevention of illnesses and
- the promotion of healthy lifestyles
and to consistently improve the healthcare delivery system by focusing on
- access,
- equity,
- efficiency,
- quality
- and sustainability.
What is the current structure of the SA health system?
Dual/Two-tiered system divided across socio-economic line
A large public sector - 84% of the population
Mainly catering for all people who do not have access to private
sector healthcare;
A private sector - 16% of the population
Catering for the health needs of people having access to private funding.
How is healthcare funded in SA?
Government funding
- General Tax
- Dedicated Health Tax
Private funding
- Medical Schemes
- -Employer
- -Individual
- Health Insurance
- -Individual
-Self Insurance
What are the current problems of the healthcare system and how will that change in the future?
Fragmented - Integrated
Hospital centred - Ambulatory
Specialist centred - Patient centred
Over-commercialtions - Value-based
What are the core principles of the NHI?
Universal access
Social solidarity
Equity
What is the purpose the NHI?
To create a
- single,
- centralized funding and administration system
consistent with the principles of
- social solidarity
- and universal coverage.
What will the NHI address?
An underfunded and overburdened public healthcare system;
A private health system that has become less affordable.
That will provide access to a benefit package of health services to all people in the country.
How will the NHI create a level playing field?
Create equitable distribution of resources resulting in high quality of health services for all the people;
Universal access to a of services for both the rich and poor
Why will the NHI be established?
To eliminate the impoverishing out-of-pocket payments and co-payments of those using the healthcare system;
To redistribute the human and material resources in a system that, at this time, is highly inequitable;
To improve the quality of health services;
To enhance access to essential services; and
To ultimately improve health outcomes for the majority of the people.
What is the definition of the NHI?
NHI is a health financing system that
- is designed to pool funds
- to provide universal access to quality, affordable personal health services
- for all South Africans based on their health needs,
- irrespective of their socio-economic status.
NHI will be implemented through the creation of a single fund that is publicly financed and publicly administered.
The health services covered by NHI will be provided free at the point of care.
NHI will provide a mechanism for improving cross-subsidisation in the overall health system.
Funding will be linked to an individual’s ability-to-pay and benefits from health services will be in line with an individual’s need for health care.
Implementation of NHI is based on the need to address structural imbalances in the health system and to reduce the burden of disease.
What are the features of the NHI?
UMCFSSS
Universal access: the right to access quality health services will be on the basis of need and not socioeconomic status.
Mandatory prepayment of health care: NHI will be financed through mandatory prepayment
Comprehensive Services: will provide a continuum of care from community outreach, health promotion and prevention to other levels of care.
Financial risk protection: ensure that individuals and households do not suffer financial hardship and/or are not deterred from accessing and utilising needed health services.
Single fund: This refers to integrating all sources of funding into a unified health financing pool that caters for the needs of the population.
Single-payer: This refers to an entity that pays for all health care costs on behalf of the population.
Strategic purchaser: utilises its power as a single purchaser
How will universal access work under the NHI?
This principle secures equality in:
- Access to a defined package of healthcare;
- Irrespective of whether it is publicly or privately funded.
Under the proposed NHI it will ensure that all South Africans have access to comprehensive quality health care services.
This means that people will be able to access:
- Health care services closest to where they live.
- The health care services will be accessed at the appropriate level of care
- and will be delivered through certified and accredited public and private providers
- Using the NHI Card.
What are principles of the NHI?
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Right to ACCESS health care
-will ensure access to health care as enshrined in the Bill of Rights, Section 27 of the Constitution:
AFFORDABILITY
-Health services will be procured at reasonable cost that recognises the need for sustainability within the context of the country’s resources.
APPROPRIATENESS
-The health system will adopt innovative service delivery models that are tailored to local needs of the population and delivered at appropriate levels of care.
EQUITY
-NHI will ensure a fair and just health system for all and that those with the greatest health needs will be provided with timely access to health services
EFFICIENCY
-Health care resources will be allocated and utilised in a manner that optimizes value for money.
EFFECTIVENESS
-the extent to which an intervention results in expected outcomes
Health care as a PUBLIC GOOD
-Health care shall not be treated like any other commodity of trade, but as a social investment.
SOCIAL SOLIDARITY
-NHI will provide financial risk pooling to enable cross-subsidisation between the young and old, rich and poor as well as the healthy and the sick
