This book examines the scope for health care reform in South Africa and Zimbabwe. Both countries are undergoing significant attempts at reforming inequitable, private sector-dominated health care systems in the context of fragile, negotiated social settlements. In South Africa, the government is moving towards introducing a national health insurance scheme that holds the historic promise of introducing social solidarity and effective health care for all its citizens. However, key aspects of the proposed scheme remain unresolved and need to be widely debated. In Zimbabwe, mandatory national health insurance has been discussed for decades without any conclusion being reached or a system implemented. This option needs to be revisited as the economy stabilises and confidence in governance improves. Based on extensive research, the contributors to this volume examine health care reform in historical context, analyse the views of key stakeholders and reflect on current proposals for better health financing and more people-centred health systems based on the principles of universality and social solidarity.