Health care insurance seeking patterns in South Africa in 2005 : a case study of civil servants

Abstract

This study investigated the influence of six background characteristics - age, Gender, marital status, province, race and salary level - on civil servants’ health insurance seeking patterns in South Africa in 2005 i.e. the outcome variable. It was based on institutional data sourced from the Department of Public Service and Administration (DPSA), compiled from 1,0I0,518 civil servants’ Employrnent\payroll records. Regrettably, non-availability of educational data may have compromised the comprehensiveness of the study. Because of the dichotomous nature of the outcome variable; Logistic Regression model was applied to the data. Additionally, frequency tables were used to present civil servants’ distribution. The study adopted a three-level analysis; univariate, bivariate and multivariate. To establish association between civil servants’ health insurance seeking behaviour and their corresponding background characteristics, Pearson’s Chi-square and probabilities were used (at 5% level). Findings of the study revealed that about one in two civil servants (49.63%) had no health insurance. Their profile in the main was; the under 50’s, mostly males, cross-cutting between the single and married, strikingly working in poor Limpopo and rich Gauteng Provinces. Africans and the lowly-paid. Encouragingly, results of the study upheld existing literature to the effect that health cover seeking patterns varied with socio-economic status (SES) - a composite index combining, among others; income, age, Gender, employment status, occupational status, educational status and area of residence. In spite of minor variations, all the background characteristics were found to be significantly associated with health cover seeking behaviour. Thus, to stimulate health cover seeking behaviour; government policies may consider national campaigns targeting employees fitting the profile presented in the preceding paragraph. Further, the state-driven universal health insurance (UHI) being mooted should be non-compulsory. Once in place, a removal of compulsory health insurance from the labour market should follow - it creates rigidity; discouraging the young from joining employers who provide it, while the old do not leave such employers, thereby stifling aggregate employment.