Fear of public hospitals drives South Africans to join medical aids

MEDICAL aid members see private healthcare cover as a necessary evil, believing that “you are screwed” if you do not have it.

A fear of public hospitals is what drives most people to have private medical cover.

This is among the findings of the first Competition Commission’s report of the Healthcare Market Inquiry.

The aim of the inquiry is to establish whether there is a lack of competition in the private health market and why medical aid and hospital prices increase above inflation every year.

The commission found that most people did not know the difference between hospital insurance and medical schemes.

GTC Healthcare Consulting head Jill Larkin said: “If you are paying less than R900 a month and are not a student, you are most likely on an insurance plan.

“The average insurance plan only pays out a certain amount of money per day in hospital and some from a third day in hospital only, which can lead consumers to be short of tens of thousands if [admitted to hospital] for serious conditions.” The report, which looks at whether consumers have sufficient information and understanding to help them choose medical aids, doctors and hospitals, says that too little information about a particular product could lead to higher prices.

It found consumers were relatively happy with their medical aid choices.

The survey of 1 500 people and smaller focus groups found that even though people complained about excessive costs, only 11% were likely to change medical aid providers and only 16% wanted to downgrade to a cheaper plan.

Of the respondents with a medical aid, 63% said they did not have broker – even though all members pay for a broker through their monthly premiums.

Larkin said this was concerning but not surprising.

“Members should consult their brokers if they have a difficulty, as they are paying for them and brokers have influence over medical aids as they sell plans.”

Of those surveyed, people who had stopped paying for medical aids said it was because they could not afford it or had lost or changed jobs.