1 / 12

Options for South Africa: Financing

Options for South Africa: Financing. Di McIntyre Health Economics Unit University of Cape Town. NHI conference December 2011, Midrand. Where from ?. WHO National Health Accounts dataset (2009 data). Where to?. WHO National Health Accounts dataset (2009 data). How to ?. Some may say:

varsha
Download Presentation

Options for South Africa: Financing

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Options for South Africa: Financing Di McIntyre Health Economics Unit University of Cape Town NHI conference December 2011, Midrand

  2. Where from ? WHO National Health Accounts dataset (2009 data)

  3. Where to? WHO National Health Accounts dataset (2009 data)

  4. How to ? Some may say: It is simple …. just make the voluntary pre-payment mandatory

  5. Voila !! WHO National Health Accounts dataset (2009 data) – not quite!!!

  6. How to ? • Make the voluntary pre-payment mandatory. But: • Only to cover part of population ? • Cover all ? Although much debate on NHI, consensus that extending medical scheme cover to all would be unaffordable (up to 25% of GDP) • Would require major reform to make schemes suitable for being part of mandatory pre-payment

  7. How to ? • Key question: • Take on massive task of reforming schemes and setting up risk equalisation; or • Continue schemes as voluntary schemes, and if so, what kind?: • Complementary: ‘Top-up’ for services and/or to cover co-payments • Supplementary: Faster access and more choice • Substitutive: ‘Double cover’ (or opt-out) • In choosing, need clarity on what is the objective?

  8. How to ? • Surest way to rebalance mandatory and voluntary pre-payment is to have a strong universal system: • Financial protection for all • Access to needed care of good quality • Transition: • Improved public funding (that benefit all) • Clearly defined role for voluntary insurance

  9. What should focus be? • Green paper - priority in first five years: • Rebuild public sector: PHC re-engineering, hospital management reform (and purchasing capacity) • This will only be possible if we gradually increase allocations from general tax revenue • Pilot districts – need to start urgently, but need to demonstrate benefits (service quality and access, good management, efficient use of resources): • Secure increased general tax funding • Build support for new earmarked taxes (and explore innovative financing)

  10. Purchasing function • Irrelevant if public or private providers if have active purchasing • Will not get efficient and equitable delivery of high quality services unless we have active purchasing: • Identify health care needs and ensure that services are available and of good quality • Change provider payment mechanisms – line-item budgets and fee-for-service out • Power to influence provider payment rates

  11. Suggested priorities • Pressure for increased allocations from general tax to health sector • Demonstrate good use of resources and delivery on the ground • Start developing purchasing capacity • Work out best sources of additional funding along the way: • Dedicated taxes (income, sin, VAT ???) • Innovative financing (financial transactions, mobile phone, etc.)

  12. Thank you www.heu-uct.org.za

More Related