The national health insurance bill: a measure to realise the right to access health care services
- Authors: Moyo, Priscilla Tariro
- Date: 2020
- Subjects: Medical laws and legislation -- South Africa , Health insurance -- South Africa
- Language: English
- Type: Thesis , Masters , LLM
- Identifier: http://hdl.handle.net/10948/49016 , vital:41593
- Description: The right to access health care services is enshrined in section 27 of the Constitution. It is a right afforded to everyone. The state is required to adopt legislative and other measures for the progressive realisation of this right. To that effect, the state has passed various pieces of legislation aimed at realising the right to access health care services. The key legislative measures regulating the health system are the National Health Act, the Medical Schemes Act and the Medicines Act. Despite the various legislative measures in place, not everyone has access to health care services and there is a need for reform in the health system. To remedy the problem of inaccessibility, the government introduced the NHI Bill in 2018 which was amended in 2019. The NHI Bill purports to amend the way in which health services are financed. The purpose of this research is to determine the constitutionality of selected aspects of the NHI Bill. Section 27(2) of the Constitution requires that any measure adopted by the state in realising the right to access health care services must be reasonable. This research, therefore, assesses whether the NHI Bill is a reasonable measure that meets the requirements of section 27(2). The NHI Bill will be assessed in light of the reasonableness review used to assess state compliance with the obligation in terms of section 27. In assessing the reasonableness of the NHI Bill, reference is made to the domestic obligations of the state to realise the right to access health care services, the context in which the NHI Bill was published, the provisions of international law, and the impact the NHI Bill will have on other rights specifically the right to equality. The findings of this research are that the NHI Bill is likely to be found unconstitutional insofar as it unfairly discriminates against asylum seekers and undocumented migrants and lacks clarity with respect to important issues such as the role of medical schemes. Based on this analysis, recommendations are made to ensure that the NHI Bill is constitutionally sound.
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- Date Issued: 2020
The medical profession and the universalisation of South African Health Care: analysing the response of Eastern Cape general practitioners to the National Health Insurance proposals
- Authors: Hannah, Bridget
- Date: 2017
- Subjects: Health insurance -- South Africa , Health insurance -- Government policy -- South Africa , Medical care, Cost of -- South Africa , National health insurance -- South Africa , Medical policy -- South Africa , Physicians -- South Africa -- Attitudes
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10962/6075 , vital:21029
- Description: In 2011, the Green Paper on National Health Insurance (NHI) in South Africa was released, committing the South African government to a 14-year plan to radically transform the currently inequitable health system towards providing comprehensive quality health care free at point of access to all citizens. The pursuit of universal health coverage (UHC) in South Africa forms part of a global aspiration to achieve more equitable healthcare delivery. One of the critical issues emerging from the Green Paper was how the NHI would be staffed. The NHI is unlikely to be adequately staffed without GPs but evidence suggests that private sector doctors have always been resistant to nationalisation or socialisation as a threat to their occupational power and professional status. The core work of this thesis is a study undertaken of 78 doctors in the Eastern Cape, focusing on private sector general practitioners (GPs), as the largest constituency of medical professionals in the country. The interview schedule was designed to gauge doctors' responses to the NHI, encourage discussion on their reactions to the reforms, and its implications in their view for private medical practice. The responses of the doctors are analysed through application of two theoretical themes, namely: (i) actor-centred policy creation, discussed through application of Walt and Gilson's (1994) shared focus on content, context, process and actors in the policy process, and (ii) the debate on medical professionalism, espoused by Freidson (1973, 1994) and argued against by Haug and Sussman (1969), and McKinlay (1972, 1993). Thus, if the process of policy making must take into account key actors in order to deliver a successful policy transition, what are the implications if these actors are actively excluded, or do not willingly cooperate? Does this indicate anything telling about the private sector's role to play in the pursuit of universal healthcare?
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- Date Issued: 2017