Affordable Medical Aids

 

Just how competitive is South Africa’s private healthcare sector?

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After a four and a half year probe initiated by South Africa’s Competition Commission, a panel of independent experts released their preliminary report into the country’s private healthcare market.

The Conversation Africa spoke to Sharon Fonn, who was on the panel of experts, about the report.

Why was a market inquiry set up?

The inquiry was set up because private healthcare and medical scheme cover is expensive in South Africa. Costs continue to rise and fewer people can afford it. People who have health insurance find that the scheme covers less care and they often have to pay out of pocket.
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3D printing disruption, medical implant sector ripe

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Medical technology which is often expensive at the time of market entry becomes cheaper over time. But 3D printing in medicine has started to revolutionise the field, especially with its rapidly declining costs and increased accessibility of the technology.

It is the technology that makes it more cost-effective. Although considerably costlier than existing implant solutions, the precision of end-product is what ensures the success of the 3D-printed medical devices. Because its designed from the thoroughly analysed digital model, 3D implants leave no room for error as compared to the traditional techniques which usually require additional processing adding waste and extraction costs.

With enhanced precision, 3D printed orthopedic and dental implants, including those that are difficult-to-treat have witnessed an impressive success rate in the past half of the decade. In line with this, a Fact.MR market study has estimated sales of medical implant segment to reach o
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Valsartan, cardiovascular medication recalled in SA

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Certain medicines containing the active pharmaceutical ingredient, valsartan, have been recalled by the South African Health Products Regulatory Authority (Sahpra) due to an impurity that was found at one of the manufacturing facilities in China that produces the molecule.

The molecule was recalled across several international markets including the USA and Europe as many originator and generic suppliers source valsartan from the same manufacturer.

The presence of the impurity, N-nitrosodimethylamine (NDMA), could be linked to changes in the way the active substance was manufactured, but a thorough investigation is currently underway to determine the exact cause. The NDMA is classified as a probable human carcinogen (carcinogen is any substance that when exposed to living tissue may cause the production of causing cancer) based on the results from laboratory tests, Sahpra said.

It stated that it will continue to investigate and assess whether the impurity may p
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The big question:- Why South Africa needs to discipline the private healthcare industry

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If a service is provided by a company rather than government, this does not automatically mean a market is at work. The point is fairly obvious but has passed many in South Africa by.

Private provision of services is moving into the spotlight in South Africa as the government looks to make the health system more accessible to the poor. One aspect is the Health Market Inquiry, established by the Competition Commission and chaired by former Chief Justice Sandile Ngcobo. It recently released a provisional report recommending more regulation of private healthcare. It has invited comment on its ideas.

It is absolutely inevitable that whatever proposals it comes up with will be attacked as an assault on the free market in health care. This will ignore the reality – that there is no market in healthcare in South Africa, at least not one which works in the way in which markets are meant to work.

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Will the HMI insights get lost in the rush to finalise healthcare laws?

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Has the almost simultaneous release of the National Health Insurance (NHI) Bill, the Medical Schemes Amendment Bill and the provisional findings of the Health Market Inquiry (HMI) created an information overload, where some of the insights from the inquiry could be lost in the noise?

“There is significant risk that the regulatory environment being created through the legislative amendment process currently underway could conflict with the lessons learned in the course of the HMI’s work, which will only be fully apparent on the release of its final report,” says Mark Arnold, principal officer of Resolution Health Medical Scheme.

A considerable amount of time, resources and expertise have been invested in the HMI, but with the final report due for release in November, however, there is a risk that the full benefit of these insights could be lost due to the timing of these inter-related developments, as the period for submissions on Medical Schemes Amen
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New Survey: Medical aid members have more choice

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In the battle for a slice of the private healthcare market, there has been significant growth in the number of medical schemes performing well across all sections of the medical aid spectrum. Whilst this means that members get more choice, it also makes the landscape increasingly complex.

The GTC 2018 Medical Aid Survey (MAS) analyses and rates medical aid schemes according to a standardised comparison and ranks the choices available to members.

When analysed purely in terms of premiums – the survey’s micro ranking – Fedhealth emerged as the medical aid which held the most top positions across all the classifications. Discovery was ranked in first place for the survey’s macro rankings, which analyses a medical aid’s overall ‘health’ and longevity in terms of factors such as its solvency level, membership growth, net healthcare result and member satisfaction. When combining both the GTC micro and macro rankings, Discovery claimed the highest number o
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These are the cheapest and most expensive medical aids in South Africa

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The latest GTC (formerly Grant Thornton Capital) Medical Aid Survey for 2018 has been released, which compares local medical aid schemes on cost to members across various levels of cover.

South Africa’s medical aid industry is facing an uncertain time ahead with government recently pushing through two new healthcare bills that are set to shake up the entire system ahead of the launch of the National Healthcare Insurance (NHI) scheme.

According to GTC, there are still many lingering questions that need to be answered in term of government’s plans – with many risks in the proposed changes that could lead to higher costs for consumers who rely of private healthcare.

“The NHI and amendments to the Medical Schemes Bill are inevitable. The disparity between the have’s (some eight million members) and the have-not’s (some 45 million) is real and needs addressing. Government intervention is urgently required,” it said.

“It is however equally importa
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South African Medical Association takes issue with Competition Commission findings

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The South African Medical Association (Sama) believes that the Competition Commission Health Market Inquiry (HMI) provisional report is faulty in its findings, particularly that doctors increase demand for unnecessary services.

In a statement, the association says that in light of the fact that the investigation took almost four years to complete and runs to hundreds of pages, it is, on first review, somewhat disappointed in the overall analysis of the private healthcare sector.

Doctor-induced moral hazard

Sama is particularly concerned about the allegations that doctors increase demand of unnecessary services, including increased admissions to hospitals, says chairperson, Dr Mzukisi Grootboom.

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You might ask the following question regarding the NHI:- Will I be able to opt out of the NHI?

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In June, the health minister released the long-awaited National Health Insurance Bill. What does it mean to you and your medical aid? We tell you.

1. Will you be able to say “thanks, but no thanks”?

If the National Health Insurance (NHI) Bill is passed in its current form, the NHI will be compulsory, regardless of whether you also belong to a private medical aid. So, opting out won’t be possible. The Bill says the NHI, which will be like a big, state-funded medical scheme, will be a free service, but it doesn’t tell us what benefits will be covered, how the scheme will be paid for or how much it will cost.

2. When will the NHI start, and, will it actually happen?

The NHI Bill says the scheme will be implemented in three phases — we’re currently in the second phase (2017 – 2022), during which NHI legislation has to be developed and the NHI fund has to be established. During the last phase, from 2022 – 2026, Cabinet
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Health Market Inquiry:- calls for medical aid schemes to be transparent

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A report by the Health Market Inquiry (HMI) looking into the private healthcare industry has recommended that there be increased transparency and improved competition.

The HMI released its provisional report on Thursday after hearing evidence from a number of stakeholders in the past three years.

The inquiry, which is chaired by the ex-Chief Justice, Sandile Ngcobo, was set up to look into the costs of healthcare and the operations of medical schemes.

“Overall we recommend changes to the way scheme options are structured to increase comparability between schemes and increase competition in that market.

Looking for a affordable Medical Aid or Hospital Plan, just click here Medical Aid or just send your Name, surname, age and email address to 082 738 5586

“A system to increase transparency on health outcomes to allow for value purch
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Hier is die 20 beste hospitale in SA

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Die resultate van die nuutste peiling onder pasiënte wat Discovery Health uitgevoer het om die beste hospitale in die land aan te wys, toon sewe hospitale wat al vier jaar agtereenvolgens op die lysie is.

Lede van mediese skemas wat deur Discovery Health geadministreer word, het aan die peiling deelgeneem oor die hospitale waar hulle in 2017 opgeneem is. Die lys is uit 140 hospitale saamgestel.

Life Healthcare, en die onafhanklike netwerk van hospitale wat lede van die National Hospital Network (NHN) is, het die meeste hospitale op die lys.

Netcare het net een hospitaal op die lys.

NHN het die meeste hospitale wat reeds vier jaar agtereenvolgens op die lys is.

Hier is die lys van die 20 beste hospitale in alfabetiese volgorde:

1. Ahmed Al-Kadi- private hospitaal (Durban, KwaZulu-Natal)

2. eThekwini-hospitaal en -hartsentrum (Durban, KwaZulu-Natal)

3. Gateway- private hospitaal (Umhlanga Rocks, KwaZulu-Natal)

4. Hillcrest- private hospitaal (
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You are paying more for less when it comes to medical aid, does it make sense. Here’s why.

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What are your chances of ending up in a hospital? Higher than you’d think if you are a medical aid member in a large city — and the reason reveals some never-before-seen truths about the country’s private healthcare sector.

A lack of competition within the private healthcare market is fuelling an epidemic of overtreatment — and mystery medical bills — in South Africa, the Competition Commission revealed on Thursday.

As part of a four-year investigation into private healthcare costs, the Competition Commission looked at hospital admission rates among patients treated in nine specialised areas of medicine. People who had insurance and lived near more hospitals were more likely to be admitted than people with similar conditions that lived farther away from lots of empty beds, the statutory body found.

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Comment on the NHI Bills presented by Health Minister

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Bonitas Medical Fund welcomes the draft amendment Bill to the end that it aims to make healthcare more accessible.

“While in principle we support the actions of the government and applaud them for taking proactive measures to improve the quality of national healthcare in South Africa, we have reservations and concerns around some of the proposed amendments. And this not only in respect of representing private medical schemes,” says Kenneth Marion, COO of Bonitas Medical Fund.

The universal National Health Insurance Bill proposed by The Minister of Health, Dr Aaron Motsoaledi, is defined by the World Health Organisation (WHO) as ‘universal health coverage means people will receive the health services they need without suffering financial hardship’.

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Medical Schemes amendments could threaten schemes’ sustainability

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While the proposed amendments to the Medical Schemes Act seek to lower the cost of private healthcare, they may have the unintended consequence of threatening the sustainability of medical schemes.

The amendments look at abolishing the practice of copayments on certain benefits, removing waiting periods and prescribed minimum benefits and tapping into the reserves medical schemes are required to hold.

These provisions in isolation could affect the financial stability of medical aids, says Lerato Mosiah, CEO: Health Funders Association (HFA). “Whilst we welcome the dialogue in the sector, it is critical that this takes into consideration the broader picture and context. It is thus important to understand that medical schemes utilise risk management measures in order to ensure that they remain viable.

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New Act could redress medical scheme sustainability issues

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Health Minister Aaron Motsoaledi has hinted at a number of reforms that directly address challenges of sustainability that the medical schemes industry is currently facing.

“We know that rising costs in healthcare are outstripping inflation, and legislated steps to address this are overdue. The proposals will usher in a new set of rules for how medical schemes operate,” says Mark Arnold, principal officer of Resolution Health Medical Scheme.

“While the details of how uniform tariffs for healthcare providers will be arrived at are not expected to be addressed in the Medical Schemes Amendment Bill, but rather will be informed by the outcome of the Competition Commission’s Health Market Inquiry, this is an important step towards protecting healthcare consumers.”

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