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“Decide what is important for your NHI”

- By Vivienne Rowland

Clear agenda setting and priorities are some of the tough choices that need to be made when a country decides on implementing a national health insurance plan.

So says Professor Tony Culyer, renowned UK health economist, who delivered a public lecture on the topic Prioritising health expenditures on the road to NHI on Monday, 23 March 2015.

Culyer, hailing from York University, is visiting Wits as a Distinguished Visiting Professor in the PRICELESS-SA unit in the Wits School of Public Health.

The talk provided South Africans with an example of acceptable evidence-based care guidance and to reflect on its relevance to the country. Culyer relayed his experiences from Wales and the UK. 

“One needs to confront the issues and the processes and decision making that will take us in the right direction and the criteria that need to be used in making the tough choices. Priority setting is obviously a tough business and there are dozens of academic and clinical voices advocating more public expenditure on health care in poor countries, but at whose, or at what expense?, asked Culyer.  “What is acceptable for one cause will be at the cost of another."

He said it is also important to decide which portion of the national budget goes to health care spending because it is easy to make a case for increased expenditure.

“Within health, there are dozens of voices advocating more spending through the public budget. Perhaps some of those are you own voices for many groups, and every one of those groups has advocates. They all say, “It is right, more should be spent”, but very few advise as to how much is appropriate or which of these should have priority. It is very easy to demonstrate, quite convincingly, that more spending on health care advances health,” said Culyer.

Culyer is the Ontario Research Professor of Health Policy and System Design in Toronto and a professor of Economics at York. He was the founding organiser of the Health Economists’ Study Group and the founding co-editor of the Journal of Health Economics.

Being a pioneer in health economics, he was the founding Vice-Chair of the National Institute for Health and Care Excellence (NICE) and is chair of NICE International’s Advisory Group. Currently he is the Editor-in-Chief of a new online Encyclopaedia of Health Economics.

Read more about Culyer.

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