Heather McLeod


Body, Mind, Soul,


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National Health Insurance in South Africa

Healthcare Financing, Policy and Reform

The African National Congress (ANC) Health Plan of 1994 outlined a structure for a National Health Insurance system alongside a National Health Service.


  • African National Congress (1994). A National Health Plan for South Africa Johannesburg: African National Congress.





From 1994 to 2003 there were a series of committees of inquiry and task teams that confirmed the need for the reform of healthcare financing and provided more detail on specific aspects of the proposal. An exellent summary of the findings from those reports is provided by Di McIntyre and Alex van den Heever in the South African Health Review of 2007.


  • McIntyre, D., & Van den Heever, A. (2007). Social or National Health Insurance. In S. Harrison, R. Bhana & A. Ntuli (Eds.), South African Health Review 2007. Durban: Health Systems Trust.





The Department of Health submission to the Taylor Committee in 2002 contains a very useful history of the public and private health sectors in South Africa. It also contains more detail on the proposed reforms to both sectors to create a single unified system, as summarised in the Taylor Committee report.


  • Department of Health (2002). Inquiry into the Various Social Security Aspects of the South African Health System: Policy Options for the Future.  14 May 2002.





While substantial work was done by the Department of Health until 2005, these documents were not in the public domain. A report prepared in 2005 was subsequently made available to  researchers.


  • Ministerial Task Team on Social Health Insurance (2005). Social Health Insurance Options: Financial and Fiscal Impact Assessment. Unpublished technical report to the Department of Health. June 2005.






From mid-2008 the ANC worked on a revised vision of National Health Insurance and a party document was released in late September 2010.


The National Health Insurance (NHI) Green Paper was released on 11 August 2011. The Green Paper is in two files and it is also important to read the Human Resource Strategy document which was initially released in August and finalised by October 2011.  

All these can be downloaded from the Department of Health pages on NHI:


• Government Notice - Policy on National Health Insurance - Section 1

• Government Notice - Policy on National Health Insurance - Section 2

• Human Resource Strategy for the Health Sector: 2012/13 - 2016/17





The National Health Insurance (NHI) White Paper has still not been released (as of October 2013).



Other key documents in the health reform process can be found from links on the IMSA website:

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