Government health services principally serve those from the low and middle-income strata; whereas private facilities mainly serve the smaller subset of wealthier households and take up a significant share of overall health spending. Indeed, South Africa relies more on voluntary private health insurance financially than any other country in the world. Yet experience from both OECD and non-OECD countries shows that voluntary private health insurance rarely provides adequate coverage for the poor and those most prone to serious illness, and often has high administrative costs.