Healthcare spending in the Eastern Cape was higher than that in the Western Cape and Gauteng, but it has not been able to provide a better system than in either of the two provinces, statistics show. (Illustration: Lisa Nelson)
This is the third in a series of four short series on health expenditure in the public and private sectors. This article describes healthcare spending from April 1, 2019 to March 31, 2020. This is a simplified and edited version of this article posted on the GroundUp and Helen Suzman Foundation sites.
First published by GroundUp.
See the first part – Accidents at work and the Road Accident Fund here:
See part two – What are municipalities doing here:
It is possible to reconstitute most health expenditure between April 1, 2019 and March 31, 2020. But no information is available on the following:
- Local government expenditure directly devoted to health services financed from their own revenues;
- Direct expenses of the medical insured; and
- Direct expenditure of medical aid recipients not captured by medical aid information systems.
Every effort has been made to avoid double counting.
The main findings are as follows: Global health expenditure is estimated at R462 billion in 2019, which represents 9.0% of gross domestic product that year. Of this total, 48.7% was spent in the public sector and 51.3% in the private sector. 1.8% of overall health expenditure went to all South Africans, 43.9% to medical aid recipients and 2.0% to insured medical persons. 52.3% of overall health expenditure was for people covered neither by medical aid nor by medical insurance – this is the sum of public expenditure plus what was spent by this group in private establishments. 40.2% of overall spending was funded by spending on medical aid benefits.
Provincial government spending represented 90.3% of all government spending on health. 77.2% of health expenditure was financed by equitable provincial shares, 21.5% by conditional grants from the national government and 1.3% by provincial departmental revenues. This funding model means that provincial spending per capita does not depend on provincial GDP. Indeed, per capita, the Eastern Cape health expenditure was higher than that of the Western Cape and Gauteng and it should have financed a better system than in either of the two provinces. This is not the case.
most technical version of this article includes much more detailed information.
Two questions arise: given the large sums spent on health care in South Africa, should the system be better? And can more be done to make health spending more equitable? DM
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This notice was published: 2021-06-14 15:26:52