While it may be true to say that you can’t afford medical aid, in reality, the majority of South Africans would be totally unable to maintain their health today without some financial support in meeting the rising cost of private healthcare. State-funded facilities have deteriorated over the years and are now at the point where most are only able to provide the most basic services on a short-term basis. More seriously, waiting lists for more complex procedures have grown to the extent that many state health patients are left with no option but to seek some alternative, regardless of what it may cost, rather than risk further deterioration or even losing their lives.
In practice, over 90% of private patients can’t afford their treatment without help from a medical aid scheme. The demand for this support in South Africa has grown considerably as a direct result of the more equitable employment policies adopted under the new dispensation. For anyone fortunate enough to be employed by a reasonably large organisation, there is invariably a group scheme available to employees. Membership of a group scheme, also known as a closed or restricted scheme, offers a company lower premiums for its employees in exchange for captive membership and often, the employer will further subsidise these.
As a result, employees in such circumstances should never be in a position where they can’t afford medical aid for themselves and their dependants. For the unemployed and the self-employed there are, however, still some affordable options, although for those with no income, placing their trust in the overworked and underfunded state healthcare system remains their only choice. Ironically, the main reason for its failure to cope, resides in the fact that unlike similar systems overseas, South Africa’s is a non-contributory scheme and relies almost entirely on its funding from tax revenues.
To keep pace with advances in equipment and treatments that have seen costs spiral, increases to premiums are inevitable and they have become an annual event. To counter the risk that members can’t continue to afford medical aid, they must be modest and different schemes have adopted their own ways in which to achieve this, while the Council for Medical Schemes (CMS), the state-appointed industry regulator, must also approve their proposals.
There are a number of options that a scheme may adopt in its efforts to minimise premiums. For instance, selected benefits may be reduced. In other cases, appointing a network of preferred service providers, such as private clinics, specialists and diagnostic services, can result in more favourable costs that may then be shared by the scheme’s members. Growing the membership is a third option, but invariably incurs heavy marketing costs that mean the lower-paid often still can’t afford membership of such medical aids.
Finding affordable cover that meets the known and likely needs of members and their families is clearly a priority. Fortunately, it is a task that is not as difficult as you may have feared. KeyHealth has adopted a simple yet effective solution with a versatile range of products. Clearly explained benefits made affordable through the use of preferred and trusted providers; no “free” perks that actually add to costs, but valuable additional core benefits all ensure that you can afford medical aid on our terms.
