Universal Coverage and Equitable Subsidies 18 January 2011 National Health Insurance Policy Brief 16

Universal Coverage Source: WHO Annual Report Health Systems Financing: The path to universal coverage. Universal coverage is not, as sometimes simplistically presented, only that everyone is covered. The definition requires a reference to who is covered, for what package of healthcare and to what degree.

Source: IMSA Policy Brief 16: Universal Coverage and Equitable Subsidies Services: which services covered Direct Costs: proportion covered Population: who is covered Private primary care CAM Public NHS well-functioning Public NHS not functioning African Traditional Medicine PMBs Voluntary medical scheme packages above PMBs Work

Source: IMSA Policy Brief 16: Universal Coverage and Equitable Subsidies Services: which services covered Direct Costs: proportion covered Population: who is covered Private primary care CAM Public NHS well-functioning Public NHS not functioning African Traditional Medicine PMBs Voluntary medical scheme packages above PMBs Work

Services: which services covered Direct Costs: proportion covered Population: who is covered Private primary care CAM Public NHS well-functioning Public NHS not functioning African Traditional Medicine PMBs Voluntary medical scheme packages above PMBs Population: all covered Services: equivalent to services and cost in NHS Direct costs: reduce OOP on defined service package Source: IMSA Policy Brief 16: Universal Coverage and Equitable Subsidies

Risk-adjusted transfers for PMBs National Health Solidarity Fund Private Health Insurance Funds Employer Direct contributions for packages above PMBs Government Direct subsidy per person (total population) Income-based contribution for PMBs less direct subsidy National Health Service Risk-adjusted transfers to Provinces Risk Equalisation Fund Provincial Risk-Adjustment Formula Per capita or risk- adjusted transfers of direct subsidy Public Tax Employee Source: IMSA NHI Policy Brief 16: Universal Coverage and Equitable Subsidies

Innovative Medicines South Africa (IMSA) is a pharmaceutical industry association promoting the value of medicine innovation in healthcare. IMSA and its member companies are working towards the development of a National Health Insurance system with universal coverage and sustainable access to innovative research-based healthcare. Contact details: Val Beaumont (Executive Director) Tel: Fax: Innovative Medicines SA (IMSA) Cell: PO Box 2008, Houghton, South Africa

Material produced for IMSA by Heather McLeod