Ina Opperman

By Ina Opperman

Business Journalist


SA scores 45th out of 60 countries for cost of healthcare

How does healthcare cost in South Africa compare to other countries? Not too bad – on paper.


South Africa has scored 45th out of 60 countries for cost of healthcare in the Cost of Healthcare Index 2022 that compares raw healthcare costs, paid by government, insurance providers or citizens, to identify where different healthcare services cost the most and least.

The index analyses and compares healthcare expenditure, health insurance schemes and the cost of caring for emergency inpatients and general outpatients in different countries around the world to show levels of healthcare expenditure from before and after the Covid-19 outbreak, as well as the costs of essential care and medicines during the pandemic.

Key findings from the study include the total healthcare expenditure, average medicine price level, access to universal healthcare, voluntary health insurance, taxation and compulsory health insurance, out of pocket healthcare spending, the average cost of a Covid emergency night and the average cost of general outpatient care.

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Total healthcare expenditure

Total healthcare expenditure per capita is each country’s total expenditure on healthcare in 2019 in US dollar and includes healthcare goods and services, such as social security contributions, inpatient and outpatient care and medical goods.

In South Africa, the cost is $547. The US, at $10 921 per person, is the most expensive in the world, followed by Switzerland ($9 666), Norway ($8 007), Iceland ($6 275), Luxembourg (6 221), Denmark ($6 003), Sweden ($5 671), Germany ($5 440), Ireland ($5 429) and Australia ($5 427). Healthcare costs are the cheapest in India at $64.

Average medicine price

The average medicine price level is the average cost per dose of 13 common branded and generic medicines, including those used to treat diabetes, cardiovascular disease and asthma.

South Africa scored -14.71%. Medicine prices are highest in the US (1309.48% more than the meridian), followed by Mexico (+153.92%) and Switzerland (+143.00%), while it is lowest in Turkey, at 70.21% less.

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Access to universal healthcare

Access to universal healthcare is a score that represents how much of a country’s population has easy access to essential health services, such as reproductive, maternal, new-born and child health, infectious diseases and non-communicable diseases, as well as data on service capacity and access among the general and most disadvantaged population, with a higher score indicating greater coverage.

South Africa scored 69.

It is the highest in Canada (89) and the lowest in Nigeria (42).

Voluntary health insurance

Voluntary health insurance, as a share of total health expenditure, refers to the percentage of each country’s total spending on healthcare which comes from voluntary, private sources, including all prepaid healthcare financing schemes, such as voluntary health insurance, non-profit institution serving households (NPISH) financing schemes and enterprise financing schemes (where companies directly provide or finance health services for their employees).

South Africa scored 46.07%, which is the highest, while Norway (0.32%) was the lowest.

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Taxation and compulsory health insurance

Taxation and compulsory health insurance per capita is an assessment of the overall contribution citizens make to health care schemes through taxation and compulsory health insurance, presented as a deviation from the dataset median. A high value indicates a high price level, with values close to zero indicating the price level is close to the international median.

It includes all financing schemes aimed at ensuring access to basic health care for citizens, including government and compulsory health insurance schemes, such as social health insurance, compulsory private insurance and compulsory medical savings accounts.

South Africa scored -76.68%. It is the highest in the US (700.62% more than the meridian), followed by Norway (+509.22%) and Switzerland (+472.16%), while it was the lowest in India (-98.14%).

Out of pocket healthcare spending

Out of pocket healthcare spending is an assessment of the overall contribution households directly make from their primary income or savings towards healthcare goods and services, through standalone payments or co-payments, presented as a deviation from the dataset median.

South Africa scored -91.91%. It is the highest in Switzerland (538.38%) and the lowest in Kenya (-94.78%).

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Average cost of a Covid emergency night

The average cost of a Covid emergency night is the average overall cost of a single night, which is defined as a patient in critical condition in an ICU station with mechanical ventilation activated, in US dollars.

This cost includes laboratory analysis, drugs and fluids, disposable protective materials, care and nutrition, as well as nurse and physician labour costs.

The average cost of a covid emergency night in South Africa is $1,390, the 42nd highest in the index.

The highest cost is in the US at $20 939, followed by Norway ($11 590) and Switzerland ($9 297) and the lowest in Turkey at $92.

Average cost of general outpatient care

The average cost of general outpatient care per capita is the average cost of general outpatient care in each country, presented as a deviation from the dataset median.

Outpatient care is defined as medical procedures, tests and services provided to a patient in an ambulatory setting without requiring an overnight stay and includes general and specialized doctor consultations, blood and urine tests, x-rays and scans.

South Africa scored -14.99%. It is the highest in the US at 3 270.94% and the lowest in India at -93.35%.

The study was conducted by Medical Web Experts in partnership with Bridge Patient Portal.

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