Considerations for the implementation of the National Health Insurance

Abstract: The establishment of the National Health Insurance (NHI) provides the South African Government with an alternative means to restructure South Africa’s failing healthcare system. Calls for a NHI with the National Health Insurance Policy Paper of 2011, together with relevant legislation and programmes, have consistently formed an integral part of Government’s national effort to build a united national health system in which the public health sector plays a dominant role as provider of fi rst choice. The article provides an overview of health care pre-1994, post-1994 and then focuses on the challenges confronting the South African health care system. The article concludes that apart from certain challenges in the current NHI debate in terms of the lack of technical details on the proposed NHI system, a lack of transparency in terms of the process, as well as problems related to the exclusion of the main stakeholders in the public and private health sector, the most crucial areas of contention in this regard is the shortage of health care workers within the South African health care system. South Africa is struggling to meet its pledge for health care for all as a result of increasing staff shortages in public sector healthcare