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Table 3 Summary of comparative analytical observations from discourse analysis of global policy documents and SA NHI documents (source: author)

From: A discourse and content analysis of representation in the mainstream media of the South African National Health Insurance policy from 2011 to 2019

Discourse analysis of global policies on UHC (n = 15)

Discourse analysis of SA NHI policies (n = 5)

‘Health as a (global) public good’ discourse

 Underlying theme in texts: ensuring all people can use the health services they need; leaving no one behind; everybody’s business

Underlying theme in texts: providing health for all citizens; social solidarity; cross-subsidisation

 Driven by: principle of universalism which arose at Alma Ata declaration; linked to discourse of health as a human right; global social accountability

Driven by: global discourse of universality but conditional for citizens and those who ‘belong’ (nationalist ideology); health as a human right (SA Constitution); government attempting to redress inequalities of the past (political agenda)

Neoliberal discourse

 Underlying theme in texts: best way to achieve UHC is through a financing mechanism (health insurance); protecting people from financial hardship; private sectors ingrained role in UHC

Underlying theme in texts: NHI Fund as a strategy to move towards UHC; effective and efficient use of resources; private sectors assumed role in NHI

 Driven by: economic utility; market-based provision of care; assumption of quality care in private

Driven by: global discourse; historical context of SA; economic utility; market-based provision of care; scarcity of resources