The Department of Health has adjusted the means test used to determine who is eligible for free or discounted fees at public hospitals, a move that could bring millions more people into the social security net. The development corrects the unintended consequence of the government’s failure to adjust the means test for 15 years, despite increasing hospital fees. The situation rendered an increasing number of households on modest incomes ineligible for state support. Contrary to perception, public hospitals may charge patients for services received, using a set of tariffs that vary according to household income. The poorest households are entitled to free healthcare, those on modest incomes are charged subsidised rates and those that earn more than the upper threshold of the means test must pay in full. The extent to which hospitals collect these fees varies among the provinces. The Western Cape health department had the most efficient bill collection system, partly because it provide...

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