A decent minimum of health care in South Africa: a bioethical proposal

[摘要] ENGLISH SUMMARY: In this thesis I identify some of the major challenges faced by the current health care system of South Africa. Thereafter conceptual analyses are done with regards to what is meant by a health care system and a decent minimum of health care (DMOHC). Although several questions around possible causes of the challenges are identified, I focus on one specific question: Is the health care system chosen for South Africa able to facilitate the service delivery expected of it? And if not, how should it beamended to achieve satisfactory results? A problem statement containing three main questions is formulated:Problem 1: Is a DMOHC in principle a good idea?Problem 2: Is a DMOHC a good idea for South Africa?Problem 3: If so, what ought that decent minimum to be?With regards to question three, I propose three main changes:1. Prioritize and ration health care services at a policy level.2. Integration of the public and private health care sector, by utilizing the National Health Insurance (NHI).3. Innovations in regulating and taxing the private sector.Arguments in favour of and against each of the concepts are discussed, with conclusions being made at the end of each deliberation process. In this thesis I find that a DMOHC is in principle a good healthcare system and also a good system for South Africa. With regards to the proposed changes, I strongly support prioritizing and rationing health care servicesat policy level. The NHI will probably soon be supported with legislation and its implementation is imminent. Whether its proposed structure will be a success, is uncertain and I am highly sceptical of its lofty goals. I do not suggest the implementation of my third set of changes, although I dothink a super tax on excessive profits made by health-related businesses is more palatable than additional taxes on the general community.

[发布机构] Stellenbosch University