Abstract
This study examines catastrophic health expenditures and the potential for such payments to impoverish South African households. The analysis applies three different catastrophic expenditure measurements, and we apply them across four South African Income and Expenditure Surveys. Since households have limited resources, they are also limited in their capacity to purchase health care. Thus, if a household devotes a large share of that capacity to health care, it may not be able to cover other necessary expenses, which could be catastrophic. The measurements differ in their definition of household capacity. Despite the differences in measurements, and, therefore, results, we find limited incidence of health care expenditure catastrophe, although larger shares of capacity are being devoted to health care in more recent years. In line with the finding that catastrophe is rare, we find that very few households are subsequently impoverished, because of health care costs.
Highlights
Prior to 1994, the South African government, through apartheid, developed political, land and economic policies that structured society according to population group, gender and agebased hierachies [2]
The African majority were forced to reside in rural areas, where health systems were underfunded, while high quality care was skewed towards the health facilities serving the white minority in urban areas [4]
We extend the comparison across time to allow us to indirectly examine the gradient in financial protection over time
Summary
Prior to 1994, the South African government, through apartheid, developed political, land and economic policies that structured society according to population group, gender and agebased hierachies [2]. These restrictions greatly influenced the organisation of social life, access to basic amenities, such as: health care, labour markets and education. In health care, such discrimination meant that different population groups had their own health care departments [3]. When the new government took power in 1994, considerable effort was invested in addressing the inherited inequities from the apartheid government
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