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Achieving AccessProfessional Movements and the Politics of Health Universalism$
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Joseph Harris

Print publication date: 2017

Print ISBN-13: 9781501709968

Published to Cornell Scholarship Online: May 2018

DOI: 10.7591/cornell/9781501709968.001.0001

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South Africa: Embracing National Health Insurance—In Name Only

South Africa: Embracing National Health Insurance—In Name Only

(p.89) 4 South Africa: Embracing National Health Insurance—In Name Only
Achieving Access

Joseph Harris

Cornell University Press

Although a constellation of factors would seem to have predisposed South Africa to make major new commitments to expand access to healthcare after the fall of apartheid, embrace of National Health Insurance has taken place in name only more than 20 years later. The chapter suggests that this sad tragedy owes its fate paradoxically to dynamics of political competition that left the African National Congress unrivalled and unchallenged, with a strong mandate to rule. Torn between a desire for radical reform – that would destroy the medical schemes that serve a privileged few – and a more incremental and measured response that would leave them in place, amid a lack of political competition, the ruling party has opted for the status quo. And the entreaties of a professional movement have gone unanswered.

Keywords:   South Africa, history, National Health Insurance, healthcare, medical schemes, health reform, African National Congress, ANC, Apartheid, elections

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