Health Economics
Assessment 3
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The purpose of this final assessment is to apply learnings from the unit to conduct a critical analysis of the process of health financing reform in a specific country, namely South Africa, including how the reform process will contribute to cross-cutting goals of all health systems, namely efficiency (how much outcome is attained given health system inputs) and equity (distribution of outcomes across the population), and the role of stakeholders in, and reasons for, trying to influence reform.
South Africa is a middle-income income country in Sub-Saharan Africa that is transitioning from a two-tiered health system in which a minority of the population have access to quality health care services provided through private health insurance organisations known as medical aid schemes and the majority rely on a publicly funded health system providing protection from catastrophic health expenditure, but which is overburdened. The proposed scheme, the National Health Insurance (NHI) Policy, sets out to achieve affordable and accessible Universal Health Coverage (UHC) across the entire population.
The critical analysis comprises five tasks that should be presented sequentially:
1. Briefly discuss contextual factors impacting on health financing reform in South Africa (~250 words).
2. Present an overview of the proposed health financing changes (~500 words).
3. Use the health policy assessment framework (Rajan et al, 2022) to consider how the proposed changes to health financing are likely to impact on assessment areas for each of revenue raising, pooling, purchasing and governance. In tackling this question, discuss how the proposed changes will impact on efficiency and equity in the system (~1000 words).
4. Identify stakeholders with a vested interest in the proposed reforms and discuss reasons for their support or opposition to the changes (~1000 words).
5. Suggest two policies, other than those included in the NHI Policy, that could be considered by policy makers to improve the efficiency and equity in the South African health care system (~250 words).
The following references provide useful material for this assignment.
Michel et al J et al. Universal health coverage financing in South Africa: wishes vs reality. Journal of Global Health Reports. 2020;4:e2020061 (note supplementary material also).
Gilson, L. Reflections from South Africa on the value and application of a political lens for health financing reform. Health Systems and Reform. 2019;5(3):236-243.
The maximum word count is 3,000 words; suggested distribution across tasks is provided above. Any word count over 3,250 words will not be marked.
The assignment will be marked using the marking guides shown on the next page. It is worth 40% of the final mark in this Unit.
Submitting the assignment
• Assignments must be submitted electronically in a MSWord document through Turnitin on Blackboard.
• The due date for the assignment is Friday 7th June 2024 at 17:00 (AWST).
• Penalties will apply to late submission unless an extension has been granted.
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Marking guide (for each question)
Excellent 80% Good 70-79% Average 60-69% Poor 50-59% Unacceptable 50%
1. Contextual factors
2. Overview of proposed financing changes
3. Impact on proposed changes to health financing
4. Stakeholders with vested interest and reasons for support or opposition
5. Policy options to improve efficiency and equity
Marking guide (overall)
Excellent 80% Good 70-79% Average 60-69% Poor 50-59% Unacceptable 50%
• Excels in responding to assignment questions; demonstrates mastery of course concepts and materials
• Presents a clear, focused and compelling argument
• Good acknowledgement of the complexities of the topic • Responds well to the assignment questions, demonstrates clear understanding of course concepts and materials
• Good argument, clearly articulated in paper, though might need refining
• Reasonable acknowledgement of the complexities of the topic • Responds appropriately to the assignment questions, demonstrates basic understanding of course concepts and material
• Adequate argument, reasonably articulated in paper
• Insufficient representation of the complexities of the topic • Doesn’t fully respond to the assignment question; somewhat disconnected from course concepts and materials
• Lacks a strong argument and is not sufficiently focused
• Lack of recognition of complexities of the topic • Does not respond to the assignment questions; demonstrates limited familiarity with course concepts and materials
• No identifiable argument
• No recognition of complexities of the topic
• Arguments are thoroughly supported by strong, specific, and appropriate evidence
• Evidence is clearly analyzed and connected to the argument • Arguments are supported by relevant evidence, though not always the strongest
• Analysis of evidence is adequate but could be further development • Arguments are supported by evidence, though not consistently relevant
• Connections between argument and evidence not consistently clear • Limited evidence to support arguments
• Insufficient connections between evidence and argument • Argument is based on little or no evidence
• Connections between evidence and argument are unclear or absent
• Paper flows logically to create a cohesive argument
• Paragraphs clearly guide the reader through a progression of ideas
• Uses transitional sentences to develop strong relationships between ideas • Generally well-constructed flow of ideas
• Paragraphs are ordered thoughtfully, each paragraph relates to central argument
• Transitional sentences create a logical progression of ideas • Adequate flow of ideas
• Some connection of ideas between paragraphs
• Simple sequential rather than transitions based on logic • Paper wanders from one idea to the next, making it difficult to distil the argument
• Limited connection of ideas between paragraphs
• Paragraphs may lack topic sentences or connection of ideas • Lacking organization and coherence
• No connection of ideas between paragraphs
• Difficult to follow flow of ideas
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• Displays a unique critical voice
• Chooses words carefully, for their precise meaning
• Demonstrates thorough and thoughtful editing and revision • Displays a clear critical voice
• Uses words effectively, if too generally at times
• Demonstrates revision and editing • Attempts to display a critical voice
• Sentence structure and word choice too unfocused; wordy or confusing
• Demonstrates minor revisions and editing • Critical voice is unclear
• Simple, awkward, or monotonous sentence structure and word choices
• Minimal revisions and editing • Lacking critical voice
• Many awkward sentences
• No evident revisions or editing
• Free of spelling, grammar, and punctuation errors
• All sources are cited correctly and completely with a consistent referencing style • Almost no spelling, grammar, or punctuation errors
• Sources mainly cited correctly and completely • Contains a few spelling, grammar, or punctuation errors but these do not distract the reader from the flow of the argument
• Minor citation errors • Contains several spelling, grammar, or punctuation errors that distract the reader from the flow of the argument
• Incomplete citations • Contains many spelling, grammar, or punctuation errors that distract the reader from the flow of the information
• Missing citations
Grade: /100
Additional Feedback:
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