‘Big four’ illnesses account for 81% of medical aid claims

ACCORDING to medical aid claim statistics there is a worrying increase in the “big four” severe illnesses.

Statistics show an increase in claims for cancer, stroke, heart attacks and coronary artery bypass grafts over the past four years.

Of the R566 million worth of severe illness claims paid last year, 81% were for the big four, with cancer the highest at 64%.

Jaco Gouws, protection product head at Old Mutual, said the statistics highlight how important it is for South Africans to seek financial advice to ensure they are adequately covered in case of the unexpected. “Although it’s not something we like to think about, accidents, illness, death and disability can, and do, affect everyone.”

Gouws said cancer claims contributed more than 52% of the claims, adding that another concerning statistic was the age of many claimants – the youngest being 19.

“The need for adequate cover applies to all ages – we are all vulnerable. Empowering people to understand disability and illness as something that affects all South Africans every year is a key focus for us. It is critical to get relevant, professional financial advice throughout your life journey to ensure you are covered.”

Heart and Stroke Foundation chief executive Professor Pamela Naidoo said the statistics were “unsurprising”.

“In some ways it is not surprising, given that in South Africa, cardiovascular diseases are the second-biggest killer after HIV and Aids. There is a steady increase in the mortality and morbidity from cardiovascular diseases.”

Naidoo said the statistics were an indication of what was happening in the public health sector regarding non-communicable diseases (NCDs).

“The fact is it is preventable and the outcome will be less severe where you won’t have to undergo these bypass surgeries. There are people who are covering themselves (in private health), so can you imagine what it is like in the public sector?”

She said the government needed to set aside a budget for NCDs as “we are facing a huge problem”.

“Some have a genetic predisposition. That doesn’t mean you will get it, but if you have it and add drinking, high cholesterol and not eating healthily, you increase your risk for cardiovascular disease onset.”

The Department of Health said non-communicable diseases, which include cancers, cardiovascular causes and diabetes, accounted for 60% of deaths between 2009 and 2013.

The department’s spokesperson Mark van der Heever said the lack of exercise and not eating well were some of the contributing factors.

“Physical inactivity and unhealthy eating are considered major risk factors for a number of adverse health outcomes, including obesity, diabetes, hypertension and other cardiovascular diseases. In South Africa, NCDs account for 40% of all deaths. In the Western Cape, 17%-25% of the burden of disease is attributed to NCDs.”

He said the department had launched a campaign, Western Cape on Wellness, which promoted healthy lifestyles to prevent, reduce and better manage chronic diseases, which were “increasing at an alarming rate”.