Med­i­cal scheme hikes hurt

Con­sumers will have to pay up to 10% more

Weekend Argus (Sunday Edition) - - METRO - TSHEGO LEPULE

CASH-STRAPPED con­sumers will have to fork out more, up to 10%, for their med­i­cal aid schemes from Jan­uary.

On the back of mul­ti­ple price hikes from petrol to VAT, con­sumers are now faced with higher pre­mi­ums.

More than 8 mil­lion South Africans on med­i­cal in­sur­ance will pay an aver­age in­crease of 9.2% for Dis­cov­ery; 8.9% for Boni­tas; 10.7% for Mo­men­tum; and 8.9% for Bestmed.

The win­dow pe­riod to make ad­just­ments be­tween the dif­fer­ent plans within a scheme closes at the end of November. Dis­cov­ery Health, with over 2.8 mil­lion mem­bers, will have a 9.2% hike on aver­age. The sharpest in­crease of 10% is at the high end. Mem­bers will also pay more for chil­dren. Mo­men­tum, with around 260 000 mem­bers, will in­crease by around 10.7%, while Fed­Health’s will see an in­crease of 8.5%.

Ac­cord­ing to the 2017/2018 Coun­cil for Med­i­cal Schemes an­nual re­port, over­all con­tri­bu­tions by mem­bers stood at R179 bil­lion.

Act­ing reg­is­trar for the coun­cil, Dr Sipho Ka­bane, noted in the re­port that the fi­nan­cial per­for­mance for 80 reg­is­tered schemes was pos­i­tive in the past year, with net prof­its stand­ing at R3.5bn and re­serves at around R63.3bn.

Mem­bers are irked by th­ese in­creases, with many ques­tion­ing when the new laws would be passed to make health care more af­ford­able.

“Every year th­ese med­i­cal aids go up and it’s a struggle to af­ford it. My hus­band was able to put two of our chil­dren on his, while I had the baby and my ill fa­ther on mine,” says 46-year-old mother of three Veron­ica Adams. “But now that he has lost his job, I can­not even af­ford to add him and the chil­dren while keeping my fa­ther, who has a heart con­di­tion, on.

“I pay close to R8 000 on med­i­cal aid and, look­ing at some of th­ese in­creases for next year, I don’t know what I’m go­ing to do.”

Prin­ci­pal of­fi­cer at Fed­Health, Jeremy Yatt, said ef­forts were made to les­son the fi­nan­cial blow when con­sid­er­ing in­creases. He put the in­crease down to med­i­cal tech­nol­ogy. “Pro­ce­dures and scans that we did not have 10 years are great be­cause it means ill­nesses that could not be treated are be­ing treated. But the down­side to that is that it costs a lot more,” he said.

“We have a team of ac­tu­ar­ies and we look closely at what we can af­ford and what we can cut from our ben­e­fits to keep the con­tri­bu­tion rate down. Every year we go through this process.

“Peo­ple will join our scheme be­cause they like the ben­e­fit struc­ture and then they find they can’t af­ford it. It is a sad thing that you have this elit­ist ap­proach. As med­i­cal schemes, we are in favour of univer­sal health care and be­lieve that we can con­trib­ute to­wards it, if only the govern­ment would let us in terms of bring­ing the pri­vate health-care sys­tems into the NHI (Na­tional Health In­sur­ance).”

Re­cently Health Min­is­ter Aaron Mot­soaledi ad­dressed the Stel­len­bosch Univer­sity’s Busi­ness School on the progress of the NHI Bill and the Med­i­cal Schemes Amend­ment Bill that he in­tro­duced in June. Dr Boshoff Steenekamp, se­nior strat­egy ad­viser at Mo­men­tum Health, said the Med­i­cal Schemes Amend­ment Bill sought to deal with many of the gov­er­nance is­sues within schemes as well as curb ex­or­bi­tant salary pack­ages for those run­ning schemes.

CMS’s an­nual re­port showed that a prin­ci­pal mem­ber from Bestmed was paid R11.9 mil­lion, while Dis­cov­ery Health paid R5.13m and Boni­tas Med­i­cal Aid forked out R4.9m.

Re­mu­ner­a­tions for trustees in­creased con­sid­er­ably for GEMS and Dis­cov­ery Health which, when com­bined, ac­count for 51% of all mem­bers.

“The bill in­tro­duces some new com­pre­hen­sive ser­vice ben­e­fits but it does not de­fine them clearly. There is a set of manda­tory min­i­mum ben­e­fits which is un­de­fined. There’s some work that needs to be done on this bill, there are a lot of con­tra­dic­tions and it’s not very clear,” added Steenekamp.

Edward Bell of LifeCheq said a num­ber of is­sues had con­trib­uted to ris­ing med­i­cal scheme costs, the VAT in­crease among them.

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