A frustration that has far-reaching impacts

Many express grievances about the exorbitant cost of medical scheme cover, stating that it is affordable for only a small fraction of employed South Africans.

But what do the statistics show when it comes to medical scheme cover in South Africa, and how can private healthcare become more affordable for the average South African?

FAnews spoke to Josua Joubert, CEO and Principal Officer of CompCare Medical Scheme to shed some light on the topic mentioned.

What the statistics show

With just 8.9 million medical scheme members in South Africa, a number that has hardly changed in the last decade, Joubert said there is no denying that affordability of medical scheme products remains a challenge for most South Africans. 

“Having said this, despite the unprecedented times that our nation and our economy have lived through in recent years, the industry has seen no significant drop in membership numbers, indicating that South Africans continue to value their medical scheme membership as highly as ever,” he emphasised. 

At the same time, Joubert mentioned that the ongoing delays around the regulatory framework that would allow medical schemes to offer low-cost options to employed individuals are a significant contributing factor to the lack of balance in healthcare accessibility in our country, “a frustration that has far-reaching impacts - not least of which are suffered by the millions of South Africans who are in desperate need of affordable healthcare access,” he says. 

According to Joubert, at this stage, concrete developments are yet to occur, but there is no question that the demand for low-cost healthcare exists, as it has done for so many years before now, and will no doubt continue to exist well into the future. 

What matters now

The world, according to Joubert, has undergone a considerable shift since the pandemic. In the healthcare space, “we have certainly seen that among individuals and businesses alike, healthcare access is now viewed as a more important factor than it was previously. With this, there is also an increased demand for better service and greater value in medical scheme offerings.” 

“As an industry, we need to take this altered perspective on board. What matters now is how we take this forward with practical and sustainable steps. The time is now for being resourceful and doubling down on initiatives that put all people at the centre of healthcare solutions - solutions that can address the needs of our nation now, not in decades to come. 

Challenges in healthcare provision

Just as financial service providers have enormous scope for innovation in meeting the needs of a broad population set, Joubert said healthcare funders too have the potential to address the various healthcare needs of our employed population. “This, however, requires greater flexibility and regulatory reforms that will allow the private healthcare funding industry to evolve more quickly.” 

“Additionally, rising costs in the provision of healthcare services are unquestionably a factor - a problem that is not particular to South Africa. The ongoing global shortage of nurses is just one example of the many challenges in healthcare provision. This, however, does not mean that innovative solutions are not being sought - significant strides are being made with the help of technology which is opening up part of the way forward in increasing healthcare access,” he said. 

“Cost savings are more pressing than ever for medical scheme members. At times like these, mechanisms such as efficiency discount options can mean the difference between retaining and foregoing membership,” concluded Joubert.

Writer’s Thoughts

The challenge of affordable medical scheme cover persists in South Africa. Regulatory delays hinder the introduction of low-cost options, exacerbating healthcare accessibility imbalances. Do you believe industry adaptability, technology, and cost-saving measures could address the current healthcare challenges and ensure the accessibility of medical schemes for all South Africans? If you have any questions please comment below, interact with us on Twitter at @fanews_online or email me - myra@fanews.co.za