South Africa is defined by a dual structure, with parallel public and private sectors operating under distinct funding models serving different segments of the population. This two-tier structure is overseen by key governmental and regulatory bodies, while the healthcare system as a whole is moving toward universal coverage through the proposed National Health Insurance (NHI) scheme. Through NHI, the government is expected to become the main procurer of health goods and services, as well as investing in the public healthcare infrastructure to improve access and equity.

The public sector is tax-funded and serves the majority of the population, 84%. It encompasses a network of over 470 public hospitals and more than 3,000 clinics, managed by provincial and municipal health departments. Public sector care uses the Uniform Patient Fee Schedule (UPFS), an income-based sliding-fee system: H0 patients are fully subsidized (free care), H1–H3 are partially subsidized and pay reduced fixed tariffs, and full-paying users are charged the full schedule—i.e., a means-tested co-payment, not a universal up to 40% subsidy cap. Some services are free for all (primary healthcare, HIV/TB care, emergency care) and for specific groups (pregnant / lactating women and children <6); all other services (inpatient / outpatient / diagnostics / pharmacy) are billed at the category-specific UPFS tariffs, which differ by service type.