The role of risk adjustment in the equitable financing of National Health Insurance in South Africa

Figures & data

Figure 1: Risk cross-subsidies and income cross-subsidies

Figure 2: Provincial and district population of South Africa in 2007

Figure 3: Comparison of age and gender profiles of provinces in 2010

Figure 4: Comparison of projected HIV prevalence of provinces to 2025

Figure 5: The impact of benefit package, age and gender on the cost of health care in the private sector

Figure 6: Estimate of shape of public sector curves for 2010, expressed in 2008 rand terms

Table 1: Impact of age, gender and HIV profiles on provincial formula

	Population	Risk factors used
		Age and gender only	Age, gender, chronic disease, HIV and maternity
Year	2010	2010	2010	2015	2020
Eastern Cape	6 735 787	96.7	97.0	96.4	94.9
Free State	2 916 764	103.2	103.2	103.6	103.5
Gauteng	10 755 068	106.2	105.4	105.8	107.8
KwaZulu-Natal	10 487 602	96.3	98.6	99.6	100.0
Limpopo	5 775 790	92.5	91.8	91.0	89.2
Mpumalanga	3 811 758	94.8	95.6	96.5	96.1
North West	3 448 427	101.3	102.2	102.5	102.8
Northern Cape	1 134 530	102.7	101.0	99.5	99.0
Western Cape	5 305 787	107.7	104.3	103.0	103.0
South Africa	50 371 513	100.0	100.0	100.0	100.0

Figure 7: The ‘single payer’ model as outlined in the NHI Green Paper

Table 2: Government and personal expenditure on healthcare per beneficiary per annum in 2008

Group	Government expenditure on delivery and tax subsidies (R)	Personal expenditure on medical schemes (R)	Personal out-of-pocket expenditure on healthcare providers (R)	Total government and personal expenditure (R)
Users of government primary care and hospital services	1 950	–	–	1 950
Users of government hospital services, but private primary care	1 950	–	550	2 500
Medical scheme beneficiaries	1 600	8 000	1 700	11 300

Figure 8: Possible mandatory health insurance linked to employment, 2009

Figure 9: A possible multiple purchaser model for health care in South Africa

ASSA (Actuarial Society of South Africa), 2011. ASSA2008 full model (version ASSA2008_110309). aids.actuarialsociety.org.za/ASSA2008-Model-3480.htm Accessed 15 January 2012.

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