The National Profile on The Council for Medical Schemes
GOVERNANCE in medical schemes continues to be a challenge in the regulatory framework. Moreover, the healthcare system is marred by inequitable access to care and healthcare resources.
And it is against this backdrop that the Council for Medical Schemes (CMS) remains committed to protecting beneficiaries and medical schemes alike.
Offering this assurance Dr Elsabé Conradie, General Manager: Stakeholder Relations, says, “We do so by enforcing the provisions of the Medical Schemes Act and have over the past 16 years built a proud culture of protecting beneficiaries and medical schemes alike.”
She elaborates, “The main pillars of the Act are the requirements for open enrolment, community rating and prescribed minimum benefits (PMBs).
“Linked with the governance requirements stipulated in the Act, these provisions protect beneficiaries against discrimination based on health status and other arbitrary grounds.”
The most recent Human Development Report says inequality in access of health services results in lower levels of human development being attained than in countries which spend less on healthcare as a proportion of Gross Domestic
Product (GDP). Close to 23 percent of the Human Development Index1 globally is lost to inequality. South Africa is