Twelve percent of South Africans have medical aid cover while 23% use private healthcare at some point, even if you are on the lower end of earnings, says Bhekisisa Centre for Health Journalism deputy editor Laura Lopez Gonzalez.
Are you getting your money's worth with the high cost of private health in the country?
Eusebius McKaiser and health journalist Laura Lopez Gonzalez, Discovery Health CEO Jonathan Broomberg and Wits School of Governance's Prof. Alex van den Heever, discuss the issue of private healthcare.
Citing the competition commission, Lopez Gonzalez says South Africans are paying more for premiums.
What the Competition Commission did find was that we are paying more for premiums and we are not getting a sort of expanded care for that. What they also found is that in some ways your medical aid is covering things - so while you're in a hospital, the cover was pretty much covered, for but when you look at the care that needed to happen outside the hospital, then medical aids fell a little short.— Laura Lopez Gonzalez, Deputy Editor - Bhekisisa Centre for Health Journalism
CEO, Discovery Health Jonathan Broomberg says those who can afford private health insurance have access to some of the best care in the world and much more quickly. Without dismissing the high cost, he says this is often taken for granted.
He admits that there are structural problems in the design of the private healthcare system that is fundamentally a function of the regulatory and legislative environment.
Some of those are that medical schemes in this country by law have to accept all applicants, at the same time they can't charge premiums based on risk, they only charge premiums based on your plan...— Jonathan Broomberg, CEO - Discovery Health
Open enrollment and a community rating are key elements of social solidarity but there is no system in the world that has those two elements without also making it compulsory to belong to health insurance if you earn above a certain environment. So in the absence of that last leg, what you get is young healthy people staying out of the system and older or sick people jumping in and that drives up premiums in a significant way.— Jonathan Broomberg, CEO - Discovery Health
Van den Heever says part of the problem is that the private health system effectively has no competition.
It is important to point out that the health market inquiry concluded that essentially the private health system effectively doesn't compete, it is not a competitive system. Part of that is because the structural model itself needs to be created so that you have efficient competition.— Alex van den Heever, Professor - Wits School of Governance
You have got to look at a complete set of structural interventions and one of the key ones is for instance risk equalisation, social reinsurance....you want to make sure that when any scheme takes on a member that they don't feel that they want to exclude somebody who is a bad risk.— Alex van den Heever, Professor - Wits School of Governance
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