The department of health is confident that SA's future economic growth will be robust enough to fund health care for an increasingly old population. But if the stubbornly high unemployment rate persists, it is unclear how a small tax base will fund not only National Health Insurance (NHI) but the additional costs associated with an ageing population. Many countries are feeling the strain on their health systems brought about by changing demographics that result in more elderly people and a smaller tax base of working younger people to support them. In Japan, the estimated population fell by 264,000 last year and deaths outnumbered births by an average of 1,000 a day, according to the International Monetary Fund (IMF). This has had an impact on the labour force, which the IMF expects will plunge by almost 24-million people by 2050. Japan is a snapshot of what is coming for many other countries, including SA. According to the World Health Organisation (WHO), by 2050 - just 26 years af...

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