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Social solidarity and civil servants' willingness for financial cross-subsidization in South Africa: implications for health financing reform

(2011) JOURNAL OF PUBLIC HEALTH POLICY. 32(suppl. 1). p.S162-S183
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Abstract
In South Africa, anticipated health sector reforms aim to achieve universal health coverage for all citizens. Success will depend on social solidarity and willingness to pay for health care according to means, while benefitting on the basis of their need. In this study, we interviewed 1330 health and education sector civil servants in four South African provinces, about potential income cross-subsidies and financing mechanisms for a National Health Insurance. One third was willing to cross-subsidize others and half favored a progressive financing system, with senior managers, black Africans, or those with tertiary education more likely to choose these options than lower-skilled staff, white, Indian or Asian respondents, or those with primary or less education. Insurance-and health-status were not associated with willingness to pay or preferred type of financing system. Understanding social relationships, identities, and shared meanings is important for any reform striving toward universal coverage.
Keywords
GERMANY, CARE, COVERAGE, PERSPECTIVE, INSURANCE, South Africa, vertical equity, universal coverage, social solidarity, health reforms, civil servants, KOREA

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MLA
Harris, Bronwyn, et al. “Social Solidarity and Civil Servants’ Willingness for Financial Cross-Subsidization in South Africa: Implications for Health Financing Reform.” JOURNAL OF PUBLIC HEALTH POLICY, vol. 32, no. suppl. 1, 2011, pp. S162–83, doi:10.1057/jphp.2011.23.
APA
Harris, B., Nxumalo, N., Ataguba, J. E., Govender, V., Chersich, M., & Goudge, J. (2011). Social solidarity and civil servants’ willingness for financial cross-subsidization in South Africa: implications for health financing reform. JOURNAL OF PUBLIC HEALTH POLICY, 32(suppl. 1), S162–S183. https://doi.org/10.1057/jphp.2011.23
Chicago author-date
Harris, Bronwyn, Nonhlanhla Nxumalo, John E Ataguba, Veloshnee Govender, Matthew Chersich, and Jane Goudge. 2011. “Social Solidarity and Civil Servants’ Willingness for Financial Cross-Subsidization in South Africa: Implications for Health Financing Reform.” JOURNAL OF PUBLIC HEALTH POLICY 32 (suppl. 1): S162–83. https://doi.org/10.1057/jphp.2011.23.
Chicago author-date (all authors)
Harris, Bronwyn, Nonhlanhla Nxumalo, John E Ataguba, Veloshnee Govender, Matthew Chersich, and Jane Goudge. 2011. “Social Solidarity and Civil Servants’ Willingness for Financial Cross-Subsidization in South Africa: Implications for Health Financing Reform.” JOURNAL OF PUBLIC HEALTH POLICY 32 (suppl. 1): S162–S183. doi:10.1057/jphp.2011.23.
Vancouver
1.
Harris B, Nxumalo N, Ataguba JE, Govender V, Chersich M, Goudge J. Social solidarity and civil servants’ willingness for financial cross-subsidization in South Africa: implications for health financing reform. JOURNAL OF PUBLIC HEALTH POLICY. 2011;32(suppl. 1):S162–83.
IEEE
[1]
B. Harris, N. Nxumalo, J. E. Ataguba, V. Govender, M. Chersich, and J. Goudge, “Social solidarity and civil servants’ willingness for financial cross-subsidization in South Africa: implications for health financing reform,” JOURNAL OF PUBLIC HEALTH POLICY, vol. 32, no. suppl. 1, pp. S162–S183, 2011.
@article{2054748,
  abstract     = {{In South Africa, anticipated health sector reforms aim to achieve universal health coverage for all citizens. Success will depend on social solidarity and willingness to pay for health care according to means, while benefitting on the basis of their need. In this study, we interviewed 1330 health and education sector civil servants in four South African provinces, about potential income cross-subsidies and financing mechanisms for a National Health Insurance. One third was willing to cross-subsidize others and half favored a progressive financing system, with senior managers, black Africans, or those with tertiary education more likely to choose these options than lower-skilled staff, white, Indian or Asian respondents, or those with primary or less education. Insurance-and health-status were not associated with willingness to pay or preferred type of financing system. Understanding social relationships, identities, and shared meanings is important for any reform striving toward universal coverage.}},
  author       = {{Harris, Bronwyn and Nxumalo, Nonhlanhla and Ataguba, John E and Govender, Veloshnee and Chersich, Matthew and Goudge, Jane}},
  issn         = {{0197-5897}},
  journal      = {{JOURNAL OF PUBLIC HEALTH POLICY}},
  keywords     = {{GERMANY,CARE,COVERAGE,PERSPECTIVE,INSURANCE,South Africa,vertical equity,universal coverage,social solidarity,health reforms,civil servants,KOREA}},
  language     = {{eng}},
  number       = {{suppl. 1}},
  pages        = {{S162--S183}},
  title        = {{Social solidarity and civil servants' willingness for financial cross-subsidization in South Africa: implications for health financing reform}},
  url          = {{http://doi.org/10.1057/jphp.2011.23}},
  volume       = {{32}},
  year         = {{2011}},
}

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