Health care inequity in South Africa and the public-private mix

Abstract

This working paper presents information and analyses of health care inequity in\nSouth Africa, with specific reference to what health economists term the publicprivate\nmix in health care. The paper identifies the apartheid legacy of disadvantage\nin terms of health status and inequitable access to health care, and outlines health\npolicy initiatives since 1994.It draws together household survey data and other\nevidence to highlight three aspects of the South African health system since that\ndate:\n1. increased use of the private sector (all forms of provider) across population\ngroups;\n2. stagnation of government funding for publicly-provided health care, which has\nimplications for quality of care and household utilisation preferences;\n3. cost escalation in, growth of, and attraction of health personnel to, the private\nsector, and the implications this has for the sustainability of the overall health\nsystem, given household utilisation preferences.\nThis working paper largely draws upon existing sources and material, but also\nincludes a new analysis of health care utilisation data. The paper provides\nbackground material for further assessment of the potential for public-private\ninteractions to support greater cross-subsidy between population groups.

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