This brings pressure to bear throughout the system.
But we shouldn't let our broad economic concerns make us hesitant or half-hearted about what desperately needs to be done in our health sector.
It is good to see that health care is among government's top three priorities.
As we all know, however, the best-laid plans can be ruthlessly upset by the market. We need cool heads and a visionary approach to ensure the long-term good of the country is not derailed by the short-term funding pressures we face.
Government has committed itself to introducing national health insurance (NHI) and we can hold it accountable on this. Indeed, there are many positive signs emanating from the NHI process.
Health minister Aaron Motsoaledi has started to air his own views on the reform of the health sector and a national advisory team has begun its work. The department's 10-point plan sets March 2010 as the date by which the NHI bill is to be tabled for public comment and everybody in the sector is waiting eagerly for a first look at the draft legislation.
The recent push to bring public-sector salaries more in line with the private sector's, through the "occupation-specific dispensation", is already having an impact. Health practitioners are now having to think twice before leaving the public sector.
There is also talk about engaging other governments to see how we can use their skills surpluses.
Perhaps we are seeing the start of the "business unusual" approach that we need if we are to address some of our challenges.
But there are still areas that need our attention if we are to build a system that will provide the quality health care all South Africans deserve.
We need to accelerate the improvement of public health-care facilities through efficient public-private partnerships. The budget speech made this point again, committing government to broadening the use of these partnerships in the health sector, in particular improving our hospital system.
We also have to create more incentives for the deductibility of health-care expenditure, whether in relation to contributions to medical aid schemes or expenditure incurred by employers.
' We need to accelerate the improvement of public health-care facilities through efficient public-private partnerships'
We need every cent we can get to support and improve health care. Now, when money is tight and jobs are vulnerable, is not the time to be discouraging people from contributing to the best health-care provision they can afford. If we do this, they will naturally feel inclined to sit back and let the burden fall on the state and on the NHI.
The health-care sector is acutely vulnerable to market fluctuations and the global hard times have been felt keenly. We need to find a way in future of ensuring the sector is recession-proof by encouraging as many people and employers as possible to make provisions for themselves and their families.
This thinking is along the same lines as finance minister Pravin Gordhan's support for further broadening access to medical scheme membership by increasing the monthly monetary caps for deductible medical scheme contributions.
If we fail to help people take care of themselves and we allow an already overburdened public sector to take even more strain, the ultimate goal of nation-building will itself come under pressure.
Blum Khan is CEO of Metropolitan Health Group
