SSL2601-STUDY-UNIT-7-Health-Care.pdf - STUDY UNIT 7 Health Care Discuss healthcare in South Africa as well as public and private healthcare Section

SSL2601-STUDY-UNIT-7-Health-Care.pdf - STUDY UNIT 7 Health...

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Unformatted text preview: STUDY UNIT 7: Health Care Discuss healthcare in South Africa as well as public and private healthcare Section 27(1)(a) and (3) of the Constitution of the Republic of South Africa specifically mentions the right of everyone to have access to health care services, including reproductive health care, and the right not to be refused emergency medical treatment. Health care in South Africa is characterised by a distinction between public and private provisioning. Private medical schemes are often linked to occupation in the formal sector and are governed by the Medical Schemes Act 131 of 1998. Public as well as private health care play important roles in every health care system. As background to this study unit you should note that South Africa’s present health care system is known as a two-­‐tier system as it comprises two main components, namely public and private health care systems. Although the system has a public component (meaning that the funding for this part of the system is provided by government) the public system in South Africa is very limited and does not allow everyone in the country to have proper access to medical care. Why is it important to have a proper healthcare system? A proper health care system is very important as healthy people can look for work, support themselves and their families and contribute to society. On the other hand, sick people increase the burden on the country’s social security system, the social assistance system in particular. Discuss the concept of health care and state what the Constitutional Court stated in determining what amounts to a health life The World Health Organisation (WHO) defines health as “a state of complete physical, mental and social well-­‐being and not merely the absence of disease”. The Department of Health in South Africa, regards “health” as more than simply the absence of disease. Health services, encompassing promotive, preventative and curative services; and the crucial role of environmental factors such as clean water and sanitation and education, are recognised as fundamental to the improvement of the health status of individuals and populations. In determining what amounts to a health life, the Constitutional Court in Soobramoney v Minister of Health, KwaZulu-­‐Natal stated that: 1 “A healthy life depends upon social interdependence, the quality of air, water, and sanitation which the state maintains for the public good; the quality of one’s caring relationships, which are highly correlated to health; as well as the quality of health care and support furnished officially by medical institutions and provided informally by families, friends and the community”. Health is one of the nine classical risks covered in the ILO Convention on Social Security (Minimum Standards), Convention 102 of 1952. Discuss the Constitutional Right to Health Care in South Africa The South African Constitution entrenches a range of socio-­‐economic rights, including the right to health care. Section 27 of the Constitution provides as follows: -­‐ (1) Everyone has the right to have access to o (a) health care services, including reproductive health o (b) sufficient food, water, and o (c) social security, including, if they are unable to support themselves and their dependents, appropriate social assistance. -­‐ (2) The state must take reasonable legislative and other measures, within its available resources, to achieve the progressive realisation of each of these rights. -­‐ (3) No one may be refused emergency medical treatment. However, section 27 of the Constitution is not the only provision dealing with rights concerning health as section 12(2) provides everyone with the right, to, amongst other things, bodily and psychological integrity, including the right to make decisions concerning reproduction, and not to be subjected to medical or scientific experiments without their consent. Similarly, everyone has a right to an environment that is not harmful to their health (s 24(a) of the Constitution), and everyone who is incarcerated by the state, including every sentenced prisoner, has a right to conditions of detention that are consistent with human dignity, including the provision at state expense of adequate medical treatment (s 35(2) (e) of the Constitution). It must be noted that there are also provisions/rights in the Constitution that have an indirect bearing on the right to health care. These rights include, amongst others, the right to equality, human dignity, life, housing, food, water, and social security. 2 Discuss reform of the South African Health Care System THE AFRICAN HEALTH CARE SYSTEM The overriding aim of health reform since 1994 has been to undo the effects of the past and to fulfil a promise made in the Constitution to build a “democratic state founded on the values of human dignity, the achievement of equality and the advancement of human rights and freedoms”. Good health and access to health care services are essential for people’s rights to dignity and are both core values of our Constitution. In April 1997, the government published its White Paper for the Transformation of the Health System in South Africa to improve health through achieving a new mission, goals and objectives for the health sector. In terms of the White Paper, in future the national health system in this country should aim to provide “caring and effective services through a primary health care approach”. The White Paper found that the main challenge was to establish an integrated health system and an effective referral system between the different levels of care. The objective is to ensure that most people enter the health system at the primary care level, where they receive basic care and health education, and that more complicated health care services are dealt with by district and specialist hospitals. The most important reforms in the area of health care in this regard include the introduction of the National Health Insurance (NHI) scheme in South Africa. The NHI will improve health service provision and health care delivery in this country. It will also make sure that all the people have access to affordable and quality health services regardless of their employment status. Describe how the public healthcare system is funded; and discuss the funding of the private health care system The public health care system is funded by government through general taxation. The private health care system on the other hand is accessible to a restricted number of the South African population, mainly due to financial implications. Private health care in this country is funded through contributions made to medical aid schemes of which individuals become members in order to insure themselves against the risk of ill health. Membership of these medical aid schemes is generally based on the condition of employment. The main difference between the public and private health care systems is that the public health care system is funded through taxpayers’ money, whilst with the private health care system, individuals pay from their own pockets or insure themselves and their families by joining and making contributions to medical funds/medical aid schemes. 3 Discuss the medical schemes act of 131 of 1998 Medical or health insurance is aimed at providing cover for the occurrence of a health risk, whether or not treatment is received. For example, the mere fact that a person is ill and unable to work will mean that he or she is entitled to the payment of a benefit. Medical insurance is governed by the Long-­‐term Insurance Act 52 of 1998 and the Short-­‐Term Insurance Act 53 of 1998. Medical schemes work slightly differently. A member of a medical scheme (also commonly known as a medical aid scheme) is indemnified against the actual cost of the health service rendered. For example, if a person breaks an arm and is hospitalised, the medical scheme will pay the hospital fees. Medical schemes are regulated by the Medical Schemes Act 131 of 1998. Discuss the National Health Act of 2003 This Act gives effect to section 27(2) of the Constitution of the Republic of South Africa, 1996 with regards to everyone’s right to have access to health care services, including reproductive health and section 27(3) which provides that no one may be refused emergency medical treatment. It also protects and promotes children’s rights to basic nutrition and basic health care services guaranteed by section 28(1) (c) of the Bill of Rights. The Act also sets out the rights and duties of health care providers, health workers, health institutions and users. The user’s rights include the right to full knowledge of his or her health status except where such disclosure would be contrary to the user’s best interests, diagnostic procedures and treatment options available to the user and knowledge about the benefits, risks, costs and consequences associated with each option; and the right to participate in any decision affecting his or her personal health and treatment. Discuss the Taylor committee report on South Africa’s Health Care System and mention the main recommendations made in the Taylor Report The Taylor Committee into a social security system for South Africa was appointed in 2002 to look at ways of making the overall social security system in South Africa more inclusive. Its brief included looking into the health care system. The following are the main recommendations made in the Taylor Report: 4 -­‐ -­‐ -­‐ -­‐ -­‐ Government is primarily responsible for the health care system which should be funded from tax revenue – there is, however a need for the private sector to be involved The private health sector must be regulated by the state The public health care system must maintain its role as the centre of the overall health system The public health care system must maintain its important role as a tertiary training ground for health personnel A basic minimum group of essential benefits must be provided in the public and private sectors risk-­‐pooling should be explored and three types were suggested, namely: o A universal benefit to be made available to everyone: this would be funded from a health care fund subsidised from taxes. o The present medical aid system to remain in place: this would imply, however, that since the levies would increase, and only high income earners would be able to afford the costs involved. Membership would be voluntary and people could belong to such schemes if they choose to do so. o A state-­‐sponsored medical scheme for low-­‐income earners: this would likely be used by the informal sector or middle-­‐income earners wishing to opt more cost-­‐effect cover 5 ...
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