The fact that 84 percent of the population is not covered by medical aid or health insurance, indicates the importance of the public sector health services, according to the National Treasury’s Intergovernmental Fiscal Review.

The National Health Accounts Projects reports that in 1999 less than 20 percent of the population was covered by private “institutional” financing intermediaries.

These include medical schemes, covering 16 percent of the population, health insurance products, and workplaces health services provided by private firms.

However, according to the Review, as many as 30 percent of non-scheme members may use private services on a direct payment basis.

“To broaden access to appropriate services remains a major challenge where a substantial part of the population cannot afford private health care.

With less funding the public sector has to care for a much larger number of people than the private sector,” the Review stated.

Another indicator of private sector size is the number of private sector hospital beds compared to the public sector. Private hospital beds increased from 16 415 to 24 537 in 2000. Public sector hospitals have over 110 000 beds.

Private health care expenditure increased at a rate double that of inflation between 1996 and 1998, from R24,7 billion to R33,3 billion.

There have also been steep rises in medical aid rates, as gross contributions per member increased by 20,1 percent in 1997 and 12,9 percent in 1998.

By 1999, only 16,4 percent of the population belonged to medical aids, leaving a bigger proportion of the population to rely on the public sector.
– Health-e News Service