Perceptions of the South African National Health Insurance among medical specialists and registrars

Abstract

The National Health Insurance (NHI) is a health care system proposed by the South African government (Health department), to replace the current two-tier system of the public and private sectors. It is an all-inclusive health system meant to eliminate inequality, reduce medical costs and extend medical insurance coverance to all South African citizens. The proposed financing model is pooled funds from mandatory taxation. The aim of this research is to establish perceptions of South African medical doctors (specifically specialists and registrars) towards NHI. This was done using an online questionnaire with Likert type scales. Wherein the level of agreement with NHI principles was ranked from 1 to 7; and the level of confidence in goal attainment was ranked from 1 to 5. Furthermore, the difference in NHI perceptions between the doctors’ demographics was investigated. It was found that the specialists and registrars supported the general reasons behind NHI. They did not support the funding model, doctor-choice restrictions and had low confidence in the potential for goal achievement. No significant differences were detected in the doctors’ perceptions between genders, sector of practise, professional level or type of speciality. Negative perceptions of medical professionals towards health reforms have been linked to job dissatisfaction in literature. Which has been cited as one of the important contributors to failure or delayed implementation of NHI in some countries.