Heather McLeod


Body, Mind, Soul,


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Healthcare and Social Security Reform

in South Africa

The Taylor Committee  reported in 2002 on a comprehensive framework for reform of all aspects of social security in South Africa, including retirement, healthcare, unemployment insurance and poverty relief. It is an important first document to understand the framework for healthcare and social security reform.







Taylor Committee Report, 2002

  • Department of Social Development (2002), Transforming the Present – Protecting the Future, Report of the Committee of Inquiry into a Comprehensive System of Social Security for South Africa, March 2002


The document is no longer available on the Department of Social Security website but can be downloaded here.




See also the Southern African Regional Poverty Network (SARPN) website.





Progress on Retirement Reform and Social Security Reform


The responsibility for developing the details of proposals for reform lies primarily with the Department of Social Development and National Treasury. Other stakeholders, including the South African Revenue Services (SARS) and the South African Social Security Agency (SASSA), were also party to discussions. The National Treasury website is likely to have the most recent information about the status of any reforms.


Historic documents include:

National Treasury, Social Security and Retirement Reform: Second Discussion Paper, 2007




National Treasury, Retirement reform proposals, 2013





Feasibility studies on four areas of retirement reform commissioned by the Department of Social Development for the Inter-Ministerial Task Team [Warning: large file 12.6Mb]:

                          A Universal Basic Pension

                          Benefit Design Options

                          Accreditation Framework

                          Post Retirement Medical Contributions





Papers from Social Security Retirement Reform Workshop held on 13 December 2007. Papers from the Inter-Ministerial Task Team and from stakeholders are available in several topic areas. Important summary of thinking of Inter-Departmental Task Team on design of retirement and other social security reform.






Responsibility for and Progress on Healthcare Reform


The responsibility for developing the details of proposals for reform lies primarily with the Department of Health and National Treasury. The Department of Social Development has also played a key role at times to ensure consistency with the broader social security framework. The major reform to the public health system is the extension of universal coverage through the proposed National Health Insurance (NHI).


This website has extensive material on National Health Insurance in South Africa.







Proposals for reform of private health insurance (indemnity insurance through not-for-profit medical schemes) are usually led by the Council for Medical Schemes (CMS), in conjuntion with the Department of Health and the National Treasury. The Board of Healthcare Funders (BHF) is one of the industry stakeholders in this regard.


There have been major reforms since 1999 with the introduction of open enrolment, community-rating and minimum benefits (in the form of Prescribed Minimum Benefits or PMBs). Extensive work was done on the design of a system of risk equalisation to ensure that community-rating applied across medical schemes. The proposed Risk Equalisation Fund would have allowed for both risk and income cross-subsidies and thus would have been the enabler of a system of social or national health insurance.








Proposals for changes to the regulation of non-indemnity health insurance, as sold by long-term and short-term insurance companies, have followed a joint process between the National Treasury, Department of Health, Financial Services Board (FSB) and Council for Medical Schemes (CMS). Industry stakeholders included the Association of Savings and Investments South Africa and the South African Insurance Association.


The major policy issue since 1999 has been on the demarcation between indemnity and non-indemnity health business. The National Treasury has material on the current status of this issue.

Taylor Committee:

"... of countries at comparable levels of development, South Africa is unusual in not mandating cover".

Healthcare Financing, Policy and Reform

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