ETD Collection

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    Health insurance coverage and the preference for public and private healthcare providers in South Africa: the case of outpatient healthcare services
    (2019) Godi, Khanani Theodora
    The paper sought to test if medical/health insurance coverage influences one’s preference or choice between a public and private service provider when seeking healthcare. Using the South African National Health and Nutrition Examination Survey (SANHANES) dataset conducted in 2012, we ran several regressions to test this theory. The methodology employed is based on Grossman’s theory of the demand for health. Logit and Probit regression models were used where the preference between a private/public service provider (dependent variable), is regressed against the determinants of demand for healthcare. We find that being insured (having medical aid) influences choice of healthcare facility with the likelihood of choosing private healthcare facilities over public ones. More specifically, the odds ratio of using a public facility decreases by 4.9 times when one is insured. This finding is consistent with that of Ataguba and Goudge (2012) who found that health insurance increases the use of private healthcare services. With the proposed National Health Insurance, it is likely that consumers will flood the private sector for the good quality service they could not afford without insurance. This influx may have an adverse impact on the efficiency and quality service delivery that the private healthcare sector boasts. As such, healthcare reforms such as the NHI should be coupled with quality improvement measures to enhance, monitor and maintain the performance and quality service in healthcare.
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    South African social assistance and the 2012 privatised national national payment system: an examination of insecurities and technopolitics in social grant administration and payment
    (2016) Vally, Natasha Thandiwe
    In 2012 the South African Social Security Agency (Sassa) contracted a private company, Cash Paymaster Services (CPS), to design a standardised national social assistance payment and registration system. The 2012 system was imagined by the government, the media, and by CPS, as a departure from previous social assistance design. There is a poverty of social assistance scholarship in South Africa which is inquisitive about how grants operate and the ways that we can complicate and reframe our understanding of how associated practices are enacted. I argue that understanding the 2012 system requires attention to the confluence of many factors including technologies (and the associated materiality and infrastructures), state practice (through bureaucracies of social grants), the boundaries of the state, policies and law, privatisation, and waiting. The 2012 system in practice renders claimants and grants insecure with regards to movement: grant money is prone to deductions (the movement of money over which a claimant has no control and potentially an end to movement of money altogether), claimants’ personal information is vulnerable (the unknown and unpredictable movement of data), and there is pressure on claimants’ time (a hemming-in of the free movement of claimants coupled with a lack of choice and possibilities in ‘taking up’ or ‘using’ time). The thesis explores the effects of privatisation, and the roots and revelations of technologies and infrastructures, in the administration and payment of social grants.