National Health Insurance Policy Documents

Health-e News NHI Updates

Health-e News offers regular updates on South Africa’s National Health Insurance (NHI) development. 

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NHI Guides by AHP

African Health Placements provides 2 documents that explain the NHI: what it all entails, what it means for our current healthcare system and how it will affect those in rural areas.

Download the AHP NHI Guide

Download the AHP NHI Summary


Health Insurance Around the World – Lessons for South Africa

This article from Africa Health Placements presents the South African NHI in the context of other countries’ healthcare systems.

View the article


SA Government Notice NHI Policy 1

This is Part 1 of the two part Government Gazette notice of the NHI Policy issued 12 August 2011.

SA Government Notice NHI Policy 2

This is Part 2 of the two part Government Gazette notice of the NHI Policy issued 12 August 2011.

Black Sash Comment on the NHI Green Paper

The Black Sash welcomes the clarity provided today by the Health Minister and his department on the long awaited draft policy for National Health Insurance (NHI). We broadly welcome the intention to improve the quality of our public healthcare service and we commend the government on tabling what we believe is potentially one of the most significant social policies since the roll out of social grants.

A financial feasibility review of NHI proposals for SA

National Health Insurance (NHI) has been introduced as a reform proposal for the South African health system by the African National Congress (ANC) from 2007. Until now such proposals were not seriously considered as South Africa has pursued the path of developing a public health system capable of guaranteeing universal access to health care. Proposals tabled by the ANC in September of 2010, however, propose an alternative institutional path coupled with ambitious budget bids. This chapter seeks to unpack and evaluate these most recent proposals, concentrating on their financial feasibility. Overall the chapter finds little evidence to support the central objective of the reform which seeks to raise up to 5% of Gross Domestic Product (GDP) in additional taxes to achieve a total public spend equivalent to 8% of GDP. No international precedent can be found for such a proposal, with no other developing countries spending anywhere close to this level on public health. Were such a proposal to be implemented it would require that personal tax rates rise to implausible levels, with a general doubling of tax rates. Aside from the general financial considerations the institutional proposals, involving the implementation of what is termed a “SARS-like” organisation, raise serious financial concerns. Aside from a lack of clarity over why this organisation is necessary and what institutional weaknesses it seeks to address, the ambitious list of proposed functions suggest that it will be considerably more costly than indicated. This chapter largely concludes that the ANC proposals are not implementable as proposed and are unlikely to seriously address existing weaknesses in the health system.

IMSA NHI Policy Brief

The purpose of this series of policy briefs on National Health Insurance (NHI) and the related IMSA web-site is to put in the public domain material and evidence that will progress the technical work of developing a National Health Insurance system in South Africa. This includes tools for costing NHI and evidence on where savings could be achieved in moving to a future mandatory system with universal coverage. This background brief provides resources on the debate around mandatory insurance in South Africa from the 1940s up to April 2009. The major focus is on the development of policy since the African National Congress (ANC) Health Plan of 1994. This sets the scene for the series of policy briefs on aspects of the National Health Insurance debate which will follow.

Health financing and the National Health Insurance in South Africa: An overview

This discussion paper presents a brief introduction to the principles of universal coverage and the nature and content of the proposed NHI plan. It will then move on to discuss the potential benefits and challenges of the NHI based on differing opinions held by major stakeholders.

Dept of Health Budget Vote Speech 2012 - Motsoaledi

Minister explains the two preconditions for successful implementation of the NHI.

SECTION27 and TAC Welcome Green Paper on National Health Insurance

SECTION27 and the Treatment Action Campaign (TAC) welcome the release of the Green Paper on National Health Insurance (NHI) for public comment. As organisations committed to the realisation of the right of everyone to have access to health care services, as guaranteed in section 27 of the Constitution, we value the opportunity to participate in what appears to be a clearly defined and well-considered policy development and implementation process that is to be accompanied and underpinned by legislative reform.

SA health insurance expenditure highest

Private health insurance in South Africa was estimated to contribute 42% to national expenditure. South Africa was actually a global exception in this regard, People's Health Movement spokesperson Peter Benjamin said today. He was speaking in Johannesburg at the South African launch of the third Global Health Watch book, hosted by the SECTION27 non-governmental organisation. Benjamin said private health insurance in the US contributed about 40% to national expenditure, while the average in most other countries was between 10 and 20%. According to People's Health Movement's draft report, private health insurance generally covered middle and upper income groups and formal sector employees. Benjamin said 16% of South Africans had access to private health care, and 84% did not. – City Press.


CEGAA Resources:

We have produced a range of resources, including research and analysis reports, country assessments, training materials and tools, and Budget Briefs. For a selection of these, go to our Products page.


Other Related Resources:

Through our project research, communications within our network, and media scanning, CEGAA regularly sources useful material and details of related organisations. For access to these, go to the Useful Links page and our  Media Dossiers.