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

Thesis (MA)--Stellenbosch University, 2018.

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Main Author: Fourie, Francois
Other Authors: Van Niekerk, Anton A.
Format: Thesis
Language:en_ZA
Published: Stellenbosch : Stellenbosch University 2018
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access_status_str Open Access
author Fourie, Francois
author2 Van Niekerk, Anton A.
author_browse Fourie, Francois
Van Niekerk, Anton A.
author_facet Van Niekerk, Anton A.
Fourie, Francois
author_sort Fourie, Francois
collection Thesis
dc_rights_str_mv Stellenbosch University
description Thesis (MA)--Stellenbosch University, 2018.
format Thesis
id oai:scholar.sun.ac.za:10019.1/103356
institution Stellenbosch University (South Africa)
language en_ZA
last_indexed 2026-06-10T12:41:44.687Z
license_str Other — see source repository
provenance_str_mv Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository
publishDate 2018
publishDateRange 2018
publishDateSort 2018
publisher Stellenbosch : Stellenbosch University
publisherStr Stellenbosch : Stellenbosch University
record_format dspace
source_str SUNScholar — Stellenbosch University Repository
spelling oai:scholar.sun.ac.za:10019.1/103356 A decent minimum of health care in South Africa: a bioethical proposal Fourie, Francois Van Niekerk, Anton A. Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy. Bioethics Medical ethics Decent minimum of health care Public health -- Economic aspects -- South Africa National health insurance -- South Africa Medical policy -- South Africa UCTD Thesis (MA)--Stellenbosch University, 2018. 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 be amended 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 services at 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 do think a super tax on excessive profits made by health-related businesses is more palatable than additional taxes on the general community. AFRIKAANSE OPSOMMING: In hierdie tesis identifiseer ek van die mees vernaamste uitdagings wat deur die Suid-Afrikaanse gesonheidstelsel ondervind word. Daarna doen ek konseptuele ontledings van wat bedoel word met ‘n gesondheidstelsel en ‘n "decent minimum of health care" (DMOHC) (behoorlike minimum van gesondheidsorg). Alhoewel daar verskeie vrae rondom moontlike oorsake van die uitdagings geidentifiseer is, focus ek op een spesifieke vraag: Is die gesondheidstelsel wat gekies is vir Suid-Afrika daartoe in staat om die gsondheid sorg te fasiliteer wat verwag word? En indien nie, hoe moet die stelsel aangepas word om die gewenste resultate te bewerkstellig? ‘n Probleem stelling wat drie hoof vrae bevat is geformuleer: Probleem 1: Is ‘n "DMOHC" ‘n goeie sisteem in prinsiep? Probleem 2: Is ‘n "DMOHC" ‘n goeie sisteem vir Suid-Afrika? Probleem 3: In dien wel, wat sou ‘n behoorlike minimum wees? Met betrekking tot die derde vraag, maak ek drie hoof voorstelle: 1. Prioriseer en ransoneer gesondheidsdienste op 'n beleids vlak. 2. Integrasie van die publieke en privaat gesondheids sektore deur die Nationale Gesondheidsversekering. 3. Innoverende geregulering en belasting van die privaat gesondheids sektor. Argumente vir en teen elkeen van hierdie voorstelle is bespreek en afleidings is aan die einde van elkeen van hierdie prosesse gemaak. In hierdie tesis bevind ek dat ‘n "DMOHC" in prinsiep ‘n goeie gesondheidstelsel is en ook ‘n goeie stelsel vir Suid-Afrika is. Met betrekking tot die voorgestelde veranderinge, ondersteun ek ten sterkste die priorisering en ransonering van gesondheidsorg dienste op beleids vlak. Die nationale gesondheidsversekering sal waarskynlik binne kort deur wetgewing ondersteun word en geimplementering word. Of die voorgestelde struktuur van die Nasionale gesondheidsversekering suksesvol gaan wees, is onseker en ek is baie skepties oor die doelwitte wat bereik wil word. Ek ondersteun nie die implementering van my derde stel van voorgestelde veranderinge nie, maar ek dink tog dat ‘n additionele belasting op oormatige winste gemaak deur gesondheid verwante besighede, meer aanvaarbaar is as additionele belasting op die algemene publiek. Masters 2018-02-14T13:55:23Z 2018-04-09T06:53:56Z 2018-02-14T13:55:23Z 2018-04-09T06:53:56Z 2018-03 Thesis http://hdl.handle.net/10019.1/103356 en_ZA Stellenbosch University 134 pages application/pdf Stellenbosch : Stellenbosch University
spellingShingle Bioethics
Medical ethics
Decent minimum of health care
Public health -- Economic aspects -- South Africa
National health insurance -- South Africa
Medical policy -- South Africa
UCTD
Fourie, Francois
A decent minimum of health care in South Africa: a bioethical proposal
title A decent minimum of health care in South Africa: a bioethical proposal
title_full A decent minimum of health care in South Africa: a bioethical proposal
title_fullStr A decent minimum of health care in South Africa: a bioethical proposal
title_full_unstemmed A decent minimum of health care in South Africa: a bioethical proposal
title_short A decent minimum of health care in South Africa: a bioethical proposal
title_sort decent minimum of health care in south africa a bioethical proposal
topic Bioethics
Medical ethics
Decent minimum of health care
Public health -- Economic aspects -- South Africa
National health insurance -- South Africa
Medical policy -- South Africa
UCTD
url http://hdl.handle.net/10019.1/103356
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