RESYST partners from the Health Economics Unit have published an editorial in the South African Medical Journal calling for commitment to accessible, equitable and good quality health services in light of the upcoming Universal Health Coverage Day and the release of the South African National Health Insurance White Paper.
In South Africa recent student protests have highlighted how politically and socially explosive inequitable access to social services can be. As with higher education ‘the missing middle’ of the South African population face financial barriers to accessing health services including high user fees, indirect costs such as transport, and unsustainable monthly fees for medical insurance schemes.
After examining trends in government expenditure on health care, which show a reduction in budget allocated to health, the authors call for restrictions on government spending as a percentage of GDP to be lifted.
“If South Africa is to achieve equitable access to the full range of social services, not only at the ‘basic level’ (such as basic education and primary health care services) but also at higher levels (higher education and all levels of referral hospitals), the fiscal policy limit on government revenue as a percentage of GDP needs to be lifted. Increasing the limit is critical given the massive income inequality in South Africa.”
The paper concludes that to preserve the impetus towards universal health coverage, the Minister of Health and others need to engage with debates within Cabinet and Treasury. The Department of Health will strengthen these arguments and win trust of colleagues if it can better demonstrate achievements in health service delivery and combat corruption.
This article is based on RESYST research that aims to identify how governments can generate more of their own national resources for health.
See also RESYST policy brief on Raising Domestic Resources for Health.
