In Conversation With Joseph Mashigo - FEDUSA Chief Negotiator for the Public Service,
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South Africa’s healthcare system is once again under scrutiny, following confirmation from the Health Minister that the current healthcare financing model is too expensive and unsustainable. This acknowledgment, made during a Section 77 hearing at NEDLAC, aligns with long-standing concerns raised by organised labour and various stakeholders about the rising cost of healthcare.
At the centre of the issue is affordability. Workers across the country are facing steep increases in medical aid contributions, with some schemes implementing hikes close to 10 percent. At the same time, wage growth has remained limited, and the broader cost of living continues to rise. For many households, private healthcare—once seen as a safety net—is increasingly becoming inaccessible.
However, the crisis goes beyond individual medical schemes. The problem lies in the structure of the healthcare system itself. South Africa operates a dual system, where a well-resourced private sector serves a minority, while the majority rely on an underfunded and overburdened public system. Despite significant overall spending on healthcare, outcomes remain deeply unequal.
A major driver of rising costs is the pricing within the private healthcare sector, including hospital fees and specialist charges. Medical schemes often pass these costs onto members through increased premiums, placing the financial burden directly on workers.
This has intensified calls for reform. Organised labour is pushing for stronger government intervention, including regulation of private healthcare pricing and broader structural changes to make healthcare more accessible and equitable.
With ongoing discussions around National Health Insurance (NHI) and other reforms, the debate is shifting from whether the system is broken to how urgently it can be fixed. The key concern now is whether government can move from acknowledging the problem to implementing meaningful solutions.
At the centre of the issue is affordability. Workers across the country are facing steep increases in medical aid contributions, with some schemes implementing hikes close to 10 percent. At the same time, wage growth has remained limited, and the broader cost of living continues to rise. For many households, private healthcare—once seen as a safety net—is increasingly becoming inaccessible.
However, the crisis goes beyond individual medical schemes. The problem lies in the structure of the healthcare system itself. South Africa operates a dual system, where a well-resourced private sector serves a minority, while the majority rely on an underfunded and overburdened public system. Despite significant overall spending on healthcare, outcomes remain deeply unequal.
A major driver of rising costs is the pricing within the private healthcare sector, including hospital fees and specialist charges. Medical schemes often pass these costs onto members through increased premiums, placing the financial burden directly on workers.
This has intensified calls for reform. Organised labour is pushing for stronger government intervention, including regulation of private healthcare pricing and broader structural changes to make healthcare more accessible and equitable.
With ongoing discussions around National Health Insurance (NHI) and other reforms, the debate is shifting from whether the system is broken to how urgently it can be fixed. The key concern now is whether government can move from acknowledging the problem to implementing meaningful solutions.
