Medical schemes regulator looking into critic’s conduct

The medical schemes regulator is investigating the conduct of an actuary who accused it last week of stalling the development of cheap options for lowincome households.

The Council for Medical Schemes (CMS) has since 2015 been overseeing the development of a low-cost benefit option (LCBO) framework that will allow schemes to offer cheap primary healthcare cover.

Last week, Insight Actuaries & Consultant joint chief executive Christoff Raath told the Board of Healthcare Funders (BHF) annual conference that millions of people were paying out of pocket for private healthcare services because they could not obtain affordable cover.

“These are the families that can least afford R400 or R500 to go to a doctor.

“The question we have to ask is: why is nothing being done about it?” he told delegates on Thursday.

Raath is a member of the council’s advisory committee on LCBOs, which was established two years ago.

He said the technical work had been completed and questioned why the process was taking so long to finalise.

Council for Medical Schemes registrar Sipho Kabane said Raath’s conduct undermined the work of the LCBO advisory committee, which was continuing in earnest and was “by no means complete”.

“The CMS has taken a dim view of this conduct and is examining this against the approved code of conduct and will be taking the appropriate action to preserve the integrity of the advisory committee and its work,” he said on Friday.

“CMS’s consultation of all stakeholders should neither be vilified nor undermined as [it is part of a quest] to ensure that the final outputs enhance the quality of care for members and that no stakeholder is left behind.

“It would be amiss of the CMS to scupper those who contribute meaningfully to the process just to appease the loudest voice in the room.”