The new National Health Insurance policy in South Africa: Public perceptions and expectations

Perceptions of and support for national health insurance in South Africa�s public and private healthcare sectors

“…This is in line with what other authors have concluded, namely that, “public support for pre-payment is unlikely to be forthcoming unless there is confidence in the availability of quality health services” [4]. An important strength of this study is that SANHANES collected much more detailed information on awareness, knowledge, perceptions and support regarding national health insurance than did other surveys reported in the literature [3-7]. In addition, none of the studies published to date [3-7] provides a comparison of the survey responses of these two important groups of constituents, i.e.…”

“…These low levels of awareness and knowledge may be attributed to the fact that this survey was conducted at the very outset of the launch of the new policy, when one would not expect awareness to be very high. Nevertheless, others have also documented low levels of knowledge, despite reporting high levels of awareness [5-7]. A third main finding is that support for NHI, not surprisingly, is greater among those perceived to gain the most from the policy (improved access and financial protection) as opposed to those perceived to potentially stand to lose (higher taxes and less choice with perceived fewer benefits).…”

“…An important strength of this study is that SANHANES collected much more detailed information on awareness, knowledge, perceptions and support regarding national health insurance than did other surveys reported in the literature [3-7]. In addition, none of the studies published to date [3-7] provides a comparison of the survey responses of these two important groups of constituents, i.e. private sector users with medical aid and public sector users without medical aid, nor do these studies explore the associations between access, awareness, perceptions and support for national health insurance.…”

“…In 2008, in the early run-up to the publication of the Green Paper [4], a nationally representative survey found that users in both the public and private sectors are dissatisfied with healthcare services, which in the authors' opinion signifies that South Africans are ready for a health systems change of this nature. A more recent three-province survey conducted in 2013 shows that awareness of the NHI was generally good, expectations high, but knowledge poor [5-7]. This paper sets out to in more detail explore the significant differences in awareness, knowledge and perceptions of and support for national health insurance in South Africa among healthcare users in the private and public sectors, using data from a large nationally representative survey.…”

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“…The public sector supplies healthcare services to 82 per cent of the estimated 57.7 million South Africans (Department Statistics South Africa, 2018) and accounts for 51.5 per cent of health expenditure, whereas 48.5 per cent is spent on only 16 per cent of the population in the private sector (National Department of Health, 2018). To overcome SA's healthcare dilemma, the National Health Insurance (NHI) has been tabled to ensure quality healthcare for all South Africans (Matsoso and Fryatt, 2013;Setswe et al, 2016). The NHI is collaboration between private and public health systems, but the public health system has been criticised for poor performance of staff and facilities, mainly due to ineffective leadership and management (Rispel, 2016).…”