National Health Systems: Public Service vs. Insurance-Based Models

The recently published National Health Insurance (NHI) Green Paper by the South African government, mentions that alternative health system models may be investigated. With this in mind, and also the call for public comment on the proposal, this note explores several health system models. In addition to a theoretical description of the different systems, it offers a comparison of health outcomes, costs and patient satisfaction rates between the various models. Based on this analysis, the appropriateness of an insurance-based universal healthcare system for South Africa is questioned.