Structuring Sustainable Universal Health Care in South Africa

Intervening in debates around universal health care in South Africa, this article draws on class-based analytical tools from social medicine, political economy, and historical sociology. It is argued there are 3 keys to achieving sustainable universal health care in South Africa: addressing the socioeconomic roots of ill health; establishing a fully public, nonprofit health care system; and adequate investment in undervalued female workers who are the backbone of public health care. Each key is discussed with accompanying recommendations, using evidence from South Africa and other countries. Principal constraints are also identified through an analysis demonstrating the links between inequality, health care financing, and the monopoly structure of the South African health care industry.