THE ISSUE of the need to establish a national health insurance (NHI) system in South Africa is not a new phenomenon. The debate began more than 70 years ago.

In 1941 J Collie, the chair of the Committee of Enquiry into National Health Insurance, outlined a scheme that covered people of all races except those who lived in rural areas (largely occupied by black people), mainly because the latter were considered unable to contribute to the fund; also, there were not enough medical personnel to provide care in those areas.

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