fd5c32c6-nhi-paulbotesThe recent State of the Nation address gave President Cyril Ramaphosa the opportunity to confirm the vision of the rollout of National Health Insurance (NHI).

Equity, access, rights and participation are core elements of social justice that are essential to health promotion. The NHI presents a prime opportunity to improve social justice across South Africa, but in its current draft form, the noble vision appears to fall short in a few crucial areas, particularly relating to the extent of universal access and the rights of healthcare workers.

As with many variants of social inequality in South Africa, asymmetries in the access and quality of public health have their roots in apartheid-era segregation. Based on 2017 data from Statistics South Africa, only about 17% of the country has medical aid, with access dramatically skewed along racial lines. Although 72.4% of white people are members of medical aid schemes, the figures drop to only 20% of coloured people and 10% of black people. The burden of out-of-pocket health costs weighs heavily on the majority of South Africans…..more