Introducing a national health insurance system in South Africa: A general practitioner’s bottom-up approach to costing

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dc.contributor.authorMoosa, Shabir
dc.contributor.authorLuiz, John M
dc.contributor.authorCarmichael, Teresa
dc.date.accessioned2021-10-08T07:18:00Z
dc.date.available2021-10-08T07:18:00Z
dc.date.issued2012
dc.description.abstractBACKGROUND: The introduction of national health insurance (NHI) is an important debate in South Africa, with affordability and institutional capacity being the key issues. NHI costing has been dominated by estimates of exorbitant cost. However, capitation is not only a different payment system but also a different service delivery model, and as a result there are opportunities for risk management and efficiencies. OBJECTIVE: This study explores how private general practitioners (GPs) may choose to embrace these service delivery concepts and deal with the cost implications to meet NHI requirements. METHODS: Data were collected from 598 solo private GPs through a self-administered online questionnaire survey across South Africa. RESULTS: In spite of poor engagement with the public sector, and some challenges in costing and organisation, GPs appear to have an affordable and pro-active response to NHI capitation costing and fee setting. On average, they would accept a minimum global fee of R4.03 million to look after a population of 10 000 people for personal healthcare services. CONCLUSION: At a total cost to the country of R16.9 billion, government could affordably use GPs to develop the primary health care part of NHI to cover the entire South African uninsured population. It is anticipated that a similar approach would be successful in other developing countries.
dc.identifier.apacitationMoosa, S., Luiz, J. M., & Carmichael, T. (2012). Introducing a national health insurance system in South Africa: A general practitioner’s bottom-up approach to costing. <i>South African Medical Journal</i>, 102(10), 794 - 177. http://hdl.handle.net/11427/34879en_ZA
dc.identifier.chicagocitationMoosa, Shabir, John M Luiz, and Teresa Carmichael "Introducing a national health insurance system in South Africa: A general practitioner’s bottom-up approach to costing." <i>South African Medical Journal</i> 102, 10. (2012): 794 - 177. http://hdl.handle.net/11427/34879en_ZA
dc.identifier.citationMoosa, S., Luiz, J.M. & Carmichael, T. 2012. Introducing a national health insurance system in South Africa: A general practitioner’s bottom-up approach to costing. <i>South African Medical Journal.</i> 102(10):794 - 177. http://hdl.handle.net/11427/34879en_ZA
dc.identifier.issn0038-2469
dc.identifier.ris TY - Journal Article AU - Moosa, Shabir AU - Luiz, John M AU - Carmichael, Teresa AB - BACKGROUND: The introduction of national health insurance (NHI) is an important debate in South Africa, with affordability and institutional capacity being the key issues. NHI costing has been dominated by estimates of exorbitant cost. However, capitation is not only a different payment system but also a different service delivery model, and as a result there are opportunities for risk management and efficiencies. OBJECTIVE: This study explores how private general practitioners (GPs) may choose to embrace these service delivery concepts and deal with the cost implications to meet NHI requirements. METHODS: Data were collected from 598 solo private GPs through a self-administered online questionnaire survey across South Africa. RESULTS: In spite of poor engagement with the public sector, and some challenges in costing and organisation, GPs appear to have an affordable and pro-active response to NHI capitation costing and fee setting. On average, they would accept a minimum global fee of R4.03 million to look after a population of 10 000 people for personal healthcare services. CONCLUSION: At a total cost to the country of R16.9 billion, government could affordably use GPs to develop the primary health care part of NHI to cover the entire South African uninsured population. It is anticipated that a similar approach would be successful in other developing countries. DA - 2012 DB - OpenUCT DP - University of Cape Town IS - 10 J1 - South African Medical Journal LK - https://open.uct.ac.za PY - 2012 SM - 0038-2469 T1 - Introducing a national health insurance system in South Africa: A general practitioner’s bottom-up approach to costing TI - Introducing a national health insurance system in South Africa: A general practitioner’s bottom-up approach to costing UR - http://hdl.handle.net/11427/34879 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34879
dc.identifier.vancouvercitationMoosa S, Luiz JM, Carmichael T. Introducing a national health insurance system in South Africa: A general practitioner’s bottom-up approach to costing. South African Medical Journal. 2012;102(10):794 - 177. http://hdl.handle.net/11427/34879.en_ZA
dc.language.isoeng
dc.publisher.departmentGraduate School of Business (GSB)
dc.publisher.facultyFaculty of Commerce
dc.sourceSouth African Medical Journal
dc.source.journalissue10
dc.source.journalvolume102
dc.source.pagination794 - 177
dc.source.urihttps://dx.doi.org/10.7196/SAMJ.6072
dc.subject.otherAdult
dc.subject.otherAged
dc.subject.otherAged, 80 and over
dc.subject.otherAttitude of Health Personnel
dc.subject.otherFee-for-Service Plans
dc.subject.otherFemale
dc.subject.otherGeneral Practice
dc.subject.otherGeneral Practitioners
dc.subject.otherHumans
dc.subject.otherMale
dc.subject.otherMiddle Aged
dc.subject.otherNational Health Programs
dc.subject.otherSouth Africa
dc.titleIntroducing a national health insurance system in South Africa: A general practitioner’s bottom-up approach to costing
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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