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Private healthcare sector must play its part to deliver access

13 April 2021 National HealthCare Group
“While the burden of improved accessibility within the private healthcare context rests firmly on the shoulders of employers, the stumbling block that prohibits healthcare access for employed individuals is affordability – even more so in times of economic hardship. Until such time as the private healthcare sector is able to do its part to remove this very real hurdle, accessibility for all employed individuals will remain nothing but a pipe dream,” cautions Dr Reinder Nauta, Executive Chairman of National HealthCare Group

“While the burden of improved accessibility within the private healthcare context rests firmly on the shoulders of employers, the stumbling block that prohibits healthcare access for employed individuals is affordability – even more so in times of economic hardship. Until such time as the private healthcare sector is able to do its part to remove this very real hurdle, accessibility for all employed individuals will remain nothing but a pipe dream,” cautions Dr Reinder Nauta, Executive Chairman of National HealthCare Group

Affordability remains the stumbling block prohibiting healthcare for employed individuals

“South Africa is a country of haves and have-nots, notably so when it comes to healthcare accessibility. This has never been more apparent than during the Covid-19 pandemic,” comments Dr Reinder Nauta, Executive Chairman of National HealthCare Group, a provider of choice in the low-cost and emerging segments of the healthcare market.

“While the burden of improved accessibility within the private healthcare context rests firmly on the shoulders of employers, the stumbling block that prohibits healthcare access for employed individuals is affordability – even more so in times of economic hardship. Until such time as the private healthcare sector is able to do its part to remove this very real hurdle, accessibility for all employed individuals will remain nothing but a pipe dream,” cautions Dr Nauta.

Many would argue that if one were to look at the high cost of absenteeism, businesses stand to lose a great deal more by not dipping their hands into their pockets – even if it means digging deep.

In illustrating this dilemma Dr Nauta cites the case study of Western Cape based financial services company, Zestlife. “During the 2018 flu season their 170 contact centre staff members recorded a combined 54 sick days in a single month. It was therefore important for Zestlife to find a way to ensure that staff could access private healthcare more easily to not only reduce the number of sick days but to improve their overall health and wellness. A practical and affordable solution was needed to provide staff with easy access to general practitioners to help contain healthcare risk.

“Zestlife obtained costings of around R270 per employee per month, which would have amounted to an additional R550 800 per annum to provide healthcare cover for 170 employees. This cost structure was understandably prohibitive and a better solution had to be found. This is where the National HealthCare Group entered the picture with a total cost of R349 500 per annum for the same benefits.

“After meeting with the chief executive and his team, it was abundantly clear that the overall wellbeing of employees was of primary concern. Zestlife understood only too well how valuable primary healthcare cover would be – not only when it comes to the overall health and wellbeing of staff, but also in contributing towards the success of the company.”

Sebastian Zoutendyk, a director of Zestlife, says that more than two years later and despite the additional challenges that the Covid-19 pandemic has brought about, the company remains extremely happy with the service provided by the National HealthCare Group.

When looking at the results achieved it is easy to see why this has worked out so well for Zestlife. According to health actuary, Gary Scott of NMG the National HealthCare Group solution has decreased absenteeism from 32% to 21% for Zestlife while showing a marked increase in employee health and wellbeing between May 2019 and March 2020.

“In addition, they managed to deliver savings of around 31% per employee per month, compared to the nearest competitor solution. By December 2020 savings had further increased to 38%,” notes Scott.

“Because of National HealthCare’s reimbursement model, we are paying quite a bit less than what we were quoted. Dr Nauta indicated that making provision for R155 per employee per month would be sufficient. We expected it to be more. However, to our surprise it ended up costing around R125 per employee per month only, which is substantially better than the scenario presented to us. In fact, it is quite remarkable to think that good primary healthcare cover can be provided at such a low cost,” says a delighted Zoutendyk.

“At Zestlife, the access to primary healthcare through the NHC network of GP’s, pharmacists, dentists and pathologists is a highly valued employee benefit. And by ensuring that all our staff members have easy access to healthcare we are able to demonstrate our concern for their wellbeing. Everyone in the company – even those with medical aid benefits are now on the National HealthCare product, as this has proven to be of great benefit when medical aid savings run out.

“Our customer relationships are critical to us, but to ensure our customers’ needs and expectations are being met, we have to have healthy, conscientious, caring members of staff. The service provided by National HealthCare Group really works in favour of Zestlife and its people who now have access to private healthcare, which is delivered fast and conveniently through a national network. For us this is mutually beneficial and the cost is far outweighed by the benefits of attracting and retaining the best people and measurably lower absenteeism. Without doubt, it is the right thing to do if the business can afford it,” adds Zoutendyk.

In commenting on the Zestlife success story, Dr Nauta explains that the National HealthCare Group advocates a fresh approach outside of the traditional medical scheme or healthcare insurance models, whereby employers subscribe to the services of a network of GPs for a nominal administration fee of R45 per employee per month.

“The marked cost difference we have achieved was made possible through a well-structured product combined with our particular pay-as-you-use model, which includes an 11,400-strong national, contracted network of general practitioners, pharmacies, radiologists, pathologists and other healthcare service providers and was pivotal in terms of affordability and outcomes,” says Nauta.

“With our MediClubTM allowance model, which is underpinned by negotiated discounts on healthcare services including doctors, pathology, medicines and radiology, and a specially negotiated basked of services delivered by general practitioners, we have this well covered. In addition, the responsibility rests on the National HealthCare Group to ensure sufficient general practitioner coverage based on employee demographics,” he adds.

Dr Nauta asserts that a robust, highly effective network, forward-thinking product development and a clear understanding of the healthcare landscape are non-negotiables for any healthcare company wanting to provide an affordable, quality service.

“Only when the employee or a member of their family needs a doctor’s consultation is the employer charged for a consultation. So far, a number of corporates have adopted this employment benefit model and are seeing the return on investment it offers for a modest outlay that costs, on average, less than the employee’s Unemployment Insurance Fund contribution*,” concludes Dr Nauta.

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The second draft amendments to Regulation 28 will allow retirement funds to allocate up to 45% of their assets to SA infrastructure, with a further 10% for rest of Africa; but the equity & offshore caps remain unchanged. What are your thoughts on the proposal?

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