Paying the Price of Good Health
Heaven forbid, but for the sake of argument, let’s say you’re involved in a serious car accident – what kind of medical care do you have in case of an emergency? Are you on a medical aid or is your only option to go to a government hospital? The type of health care available to ordinary South Africans is largely determined by their income and where they live. South Africa is a land of contrasts, and this is particularly clear when it comes to the various tiers of health care in our country. From private medical aid to public health care, there’s a striking disparity between the haves and the have-nots. Let’s take a look at the three main options available.
Public health care
While the state offers basic primary health care through government hospitals and clinics, most wealthy South Africans opt for the far more expensive and comprehensive medical aid plans offered by a host of medical aid providers. Although access to health care is a constitutional right, around 80% of South Africans are reliant on the heavily-stressed, public health-care system which cannot bear the load. As a result, many treatable health issues and diseases claim more lives than they should.
The public health-care system has suffered mismanagement, a lack of funding and resources which has resulted in infrastructure degenerating. While there has been increased access to public health care, the quality of that care has worsened.
Private medical aid
On the other side of the coin is the private medical aid system comprising a variety of medical aid providers offering specialised, hi-tech services geared towards middle- and higher-income earners.
So, just how expensive is private medical aid? With each medical aid provider having varying options, making it difficult to compare like with like, we’ve done a comparison of similar medical aid schemes and their pricing structures. Discovery has the lion’s share of the market, with nearly three million customers and 54% of the private medical aid market. The five top-tier medical aid schemes that typically offer unlimited hospital cover and comprehensive day-to-day benefits are as follows:
Scheme Cost for principal member
Momentum Extender Option 2 R4 671
Resolution Health Supreme R4 565
Discovery Health Classic Comprehensive R4 506
FedHealth Maxima Executive R4 302
Discovery Health Classic Delta Comprehensive R4 059
A presentation at the Competition Commission’s health market inquiry in February 2016 by World Health Organization representatives showed that the cost of private medical aid plans has skyrocketed by more than 300% over the past 12 years. Even more shocking is the fact that South Africans are spending six times more than the international average on private health care. Another drawback is that the private sector draws many of South Africa’s top health care professionals, who leave the public sector for more lucrative opportunities.
It’s clear that this kind of spending on health-care services is well out of the reach of lower-income earners.
With the cost of medical aid schemes spiralling out of control, many people are looking for more affordable health care options. While comprehensive medical aid plans are more expensive, they cover day-to-day medical expenses such as medication, maternity programmes, as well as dental and optometry benefits, health screening, chronic treatment and even rewards programmes. Most medical aids also have a built-in medical savings account (MSA) which is used to pay for some or all day-to-day expenses.
Hospital plans are a cheaper alternative as they are aimed at treatment provided in hospital only, cutting out any extra benefits and lowering the overall cost. If you opt for a hospital plan, you are responsible for your day-to-day expenses, which may seem daunting, but many people opt to put aside a monthly amount for these expenses rather than pay into an expensive medical aid scheme with an MSA.
It’s vital to consider your health before making a switch to a hospital plan with less cover, but if your daily medical costs are likely to be relatively low, then switching could be easier on your pocket. Consider the cost of the following five hospital plans:
Scheme Cost for principal member
Discovery Health Keycare Core R1 408
FedHealth Maxima EntryZone R1 326
Discovery Health Essential Delta Core R1 317
Momentum Custom Option 1 R1 266
Genesis Private Choice R1 000
Can the NHI system bridge the gap?
There might, however, be a light at the end of the tunnel. The proposed National Health Insurance (NHI) system has been structured to pool funds to provide quality, universal health-care services to all South Africans. This financing system aims to provide access to all, regardless of income or ability to contribute to the NHI fund.
Through the proposed scheme, accredited health facilities will provide comprehensive, yet defined health-care services free of charge. Services will range from primary and secondary health care to specialised tertiary care with a strong emphasis on disease prevention and promotion of health, but will exclude services such as cosmetic or elective surgeries.
The funding for the system will be maintained via a combination of resources, but primarily through taxation. Implemented in 2012, the NHI is being rolled out over a 14-year period, but it has been met with some resistance as many higher-income earners are concerned that the system could be subject to abuse and that they will be taxed heavily to provide for those who are unable to afford quality health care for themselves. Some have voiced concern that the private medical sector will take strain as a result of the NHI, but the government has insisted that the fund will make private medical aid schemes more sustainable by regulating reasonable fees.
Something drastic needs to change – the current health-care system is deepening the gap between rich and poor while ordinary people are paying the price… with their health.
**Prices listed herein are an average and may differ upon actual purchase of the product.**