For many people, the possibility of improving life expectancy and quality of life are goals behind the drive to have private healthcare cover. But, says Dr Mangaliso Mahlaba, Chief Operating Officer of Thebe Ya Bophelo Healthcare, achieving these goals means choosing the right health cover.
Thebe Ya Bophelo Healthcare is South Africa’s foremost black-owned and –managed healthcare administrator.
“It’s well known that adopting a healthy lifestyle is the essential first step to improving our health and prolonging our lives—living longer but with reduced quality of life is not the desired outcome,” says Dr Mahlaba. “Because we need to deal with the whole person, a combination of the right lifestyle and the right health cover is vital. That way, one minimises the medical intervention needed, but it’s there when it’s required.”
The role of the provider of health cover is particularly acute when it comes to a country like South Africa, where large numbers of people are entering the private health sector for the first time. These members may need a lot of input from the health cover provider in terms of education, not just about how medical benefits work but also about nutrition, exercise and preventative care.
Thebe Ya Bophelo Healthcare, for example, is particularly active in the mining sector. It’s a market sector that epitomises many of the challenges of emerging markets. One is the large number of new members and their lack of experience with how the private healthcare system works. These members also tend to lack information about healthy lifestyle choices, as well as common medical conditions. Some may be susceptible to the “diseases of affluence” such as obesity, diabetes, heart problems and hypertension. HIV/Aids remains a continuing challenge.
“Reaching these large communities is one issue, another is building a relationship of trust with them,” explains Dr Mahlaba. “In this regard, working closely with the union is very important, because it provides a trusted platform. The employer is obviously the other important role-player. Ideally, the union, the employer and the provider of health cover should work together, united in their common concern for employees’ health.”
Health cover and lifestyle come together most clearly when a chronic condition needs to be managed, and at key moments in an individual’s life such as childbirth or when an accident occurs. However, industrial action can make a huge impact, especially when medical services are largely provided at on-site clinics. This can have devastating consequences, in particular when a chronic condition has been only brought under control with difficulty.
“We need to find ways of exempting health care from industrial action,” Dr Mahlaba argues. “One way could be for the health cover provider to leverage its own network of community-based service providers—or build one—in order to ensure continuity. Such an approach could also take care of unexpected events, like accidents. Thebe Ya Bophelo Healthcare, for example, already has such networks in the community that could be used in such circumstances.”