South African healthcare: not all doom and gloom

01 October 2008 Thokozani Magwaza, Sechaba Medical Solutions

Despite advances in medicine and technology, some of the most developed countries in the world are still grappling to find the right healthcare equation and system. Where does that leave developing countries such as South Africa?

In South Africa less than 15% of about 48 million citizens have medical aid cover. With the majority of citizens reliant on state funded healthcare, the picture looks rather gloomy.

Although the South African government contributes about 40% to all expenditure on health, there is no doubt that the public health sector is under pressure to deliver services to about 80% of the population. It is a generally agreed fact that the public health sector is under-resourced and over utilised.

Public health sector constrained

Thokozani Magwaza, CEO of Sechaba Medical Solutions says the recent exodus of the country's healthcare workers has also had a negative effect on service and delivery at public health institutions. This coupled with the fact that most of these institutions lack adequate medical equipment, ambulances, linen and medicine to provide proper care to the poor, not to mention the low morale among many of the remaining health workers.

Becoming the preferred provider?

However, former Health Minister Dr Manto Tshabalala-Msimang is adamant that the challenges facing the public sector can be resolved so that over time the public sector can become a preferred provider and not a provider of last resort.

With the help of medical schemes, government can develop and implement effective strategies that can ultimately lead to an improved healthcare system. For example, more people on private medical aid cover can help ease the burden on the government.

However, says Magwaza, as much as schemes are willing to support the government in its initiatives to make healthcare more affordable to every South African, the highly regulative legislation could have an adverse affect on scheme's reserve levels in the future.

Low-income schemes and options essential

Magwaza says at present South Africa has about 160 medical schemes, of which about 40 are open to the public. Out of the 40 medical schemes open to the public, it seems as though only a handful cater for the low-income market.

"With the ever-increasing costs and changing dynamics of smaller schemes being swallowed by bigger schemes, this might decrease even further, hence greater pressure on the development of low-income schemes and options within schemes," he says.


Studies have shown that many poor households are currently spending money on private healthcare as the burden weighs too heavily on the public healthcare system, which is unable to meet the demand.

Magwaza says this means that there is opportunity to draw many people into the private healthcare fold provided the premiums are equal to, or at least close to, what they are currently spending on public healthcare.

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