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The quest to crush the intermediary

02 October 2008 | Healthcare | General | Gareth Stokes

“If ever we needed proof that the CMS is a destructive force, we have it now.” That’s according to one FAnews Online reader who commented on our newsletter  on the Council for Medical Schemes’ (CMS) policy proposal document: “Remuneration of Health Brokers: Revising the Regulatory Framework.” Another reader feels that the CMS is on a mission to crush the intermediary. “Medical aid options have become increasingly complex with intermediaries being paid less and less for our services,” he said.

And he makes an interesting case. At an average of R57 (including Vat) per month per member a financial practice should (considering the profit motive that all businesses operate under) spend only 25 minutes with that member in a year. The fact that an independent broker will be able to negotiate fees under the proposed system provides little respite. Robbie writes: “The public’s poor view of medical aids and the insurance-broking industry in general will not encourage a market that is already sceptical of the industry to pay enough to the independent advisor to sustain his or her business.”

Members will pay more for less

Readers agree that the proposed changes will have the opposite result to that intended – saving medical aid members’ money. JEC believes that, should some of the proposals win through, tied agents would end up with more than the amount currently paid to brokers. The result: “More will be spent by schemes (not less) – and there will be no advice, only factual information about the scheme.”

And they strongly disagree that brokers are the drain on the current medical schemes environment. John says that to claim “the measly amount that the broker gets paid is the actual drain on the resources of the medical aid funds, administrators or whoever pays the commission” is a joke. If authorities want to know where the wasteful expenditure is he urges them to “look at where some of the executives of the medical aid societies and administrators live and the transport they use to get there and back!

In our view the final solution has to deliver two results. First, it has to empower the consumer to make an enlightened medical aid choice. And second, it must reduce the cost to the consumer of taking up the chosen medical aid. The independent intermediary is critical to the first par of this equation while the battle to reduce costs should be fought at medical product provider levels. That will stem from a sensible collaboration between private and public hospitals and other healthcare providers – and we’re talking about a serious about turn on the Department of Health’s current strategy.

A scary prospect

Another problem with the proposed changes to healthcare broker remuneration is the juxtaposition of information and advice. The CMS absolves the medical aid scheme of giving advice by suggesting the tied agent need only share information about the product being sold. At the same time they are making it uneconomical for the advice givers (independent brokers) to keep their doors open. That means the prospective medical aid client will eventually only have one channel to make that crucial medical aid purchase.

Consumers hate hassle. They’re not going to be too concerned if the person sitting opposite them says they only represent one medical scheme. They’re there to get cover and the marketing pamphlet is going to become the advice surrogate... The average consumer will end up knocking on the door of the medical scheme with the biggest advertising budget – where he will be informed about a single product – and purchase the product with scant knowledge of the alternatives.

Some serious rework required

It’s a good thing that the proposal is open to comment because it’s clear that a great deal more thought is required before the regulatory framework is revised. Another reader comment from Elna suggests the changes “will not enhance the medical care for any of our clients but rather worsen it!”

And we’ll end with this parting shot from Jamie: “If this is implemented it will drive more brokers from dealing with medical aids. I cannot see any improvement for clients – and they will almost certainly be worse off. Do any of the people involved in decision making have any experience in broking and dealing with clients at the ‘coal face’?”

Editor’s thoughts:
The purpose of the CMS document was to generate debate around the issue of broker remuneration in the healthcare environment. It seems there’s going to be plenty of feedback for them to digest. Will they listen to the workers at the coal face? Or will they ram another ‘hard to stomach’ bill through Parliament? In your experience, have financial advisers been able to influence the various legislative changes to the financial services industry? Add your comments below, or send them to [email protected]

Comments

Added by Grant, 03 Oct 2008
The legislators are working contrary to the governments stated objective of increasing employment. With unemployment at the high levels they are - even if the finance minister doesn't believe his own stats department - we need jobs at all costs. Most small businesses employ administrators, security personell, cleaners etc. and these people are affected by the reduction of fees/commission. Kill the bosses and you kill the workers. The same applies to long term insurance.
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Added by Forget about it, 02 Oct 2008
When clients ask me about who offers the best medical aid, I tell them to compare the various options on the internet. I haven't come across a single client yet who can't manage it on their own. It doesn't make sense for a life broker to sell medical schemes on an individual basis, in any case. Who wants clients coming to them with their medical aid claims? Get involved in medical schemes, and that's exactly what will happen. If you don't offer the service of assisting with claims, the client will ask himself: what do I need this broker for? Group schemes are another story. With group schemes, clients understand they have to send their claims in themselves, it's always been like that. Unless you have economies of scale, it doesn't pay a broker to get involved.
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Added by Craig A, 02 Oct 2008
How will the CMS survive without the funding it receives from us? In a recent article, you mentioned that there were 10,000 brokers. I pay them an average of R 1,000 per year. That means that they receive an average of R10 million from brokers every year. I'd like to know where my cash goes. They are hardly working for charity!
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Added by GT, 02 Oct 2008
I have never "approved" and recognised the CMS in my own mind as I have never come across anything they have done to favour the broker. My CMS membership fees I pay with the deepest regret and purely because I have no choice. The CMS, according to me, has only one thing in mind and that is total control of the medical aid industry, come Hell or High water, and to enrich themselves at the cost of the broker and the medical schemes. Their other goal is to eliminate as many individual schemes as possible and only promote GEMS. I still market medical aid schemes purely because my clients expect it from me and for no other reason.
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Added by Andre, 02 Oct 2008
""In your experience, have financial advisers been able to influence the various legislative changes to the financial services industry"" .....No, their are committees to represent us but on deaf ears.. the LOA and other people who make these dicisions are dam stupid..!!! For instance who is goiing to market savings plans and RA's with as and when commission form 1 Jan 2009???? ... what about the advisors cost to see the client, petrol, paperwork etc.... Advisors and brokers are a huge drive to creat welth under the public by selling these products.. I see a poor South Africa people in the future cause of bad legislations....and now product advise
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Added by Chris, 02 Oct 2008
NO! Intermediaries have not been able to influence anything as the gods in power have their own agendas. In fact I take my hypothetical hat off for your guys fighting for a good cause and sanity. I no longer have the energy to even get upset with a bunch of clowns. But thank you for your good work and intentions. Sincerely Chris van Rooyen
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Added by Sidney Pittaway, 02 Oct 2008
Gareth, before we even start with the commission issues, lets first find out who's in charge of who? and who controls who? Is it not the function of the FSB to monitor and regulate the finanmcial industry? Why then do they allow the CMS to do as they please? It appears as if the FSB has no control about the actions and decissions taken by the CMS? WAKE UP FSB!!!!!!!!! That's what you get paid to do!!!!
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Added by Elsie, 02 Oct 2008
Of course we all realise that GEMS is most propaply the reason. "Stop the Brokers from marketing the other products and have an instant client base for GEMS" Experienced Independent Financial and Medical Scheme Advisers no longer have a future in South Africa. The profession is being watered down to nothing. I think the idea is to make it so difficult and expensive to be such a person in order to get rid of the knowlegeable to enable the uncompetent and unexperienced to do the job cheaper by way of sales agents and all those other fancy names they give it. The insurance and medical industry may soon do only business over the counter of some shop owner of by way of the telephone.
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Added by Jean, 02 Oct 2008
Hi Gareth, Two issues arise in my opinion. (I have not read other comments so might be repetative) 1. If we as independents implement a fee structure, will our clients then be provided with a cheaper medical aid contibution ie will our clients be given the credit because the medical aid funds do not pay us commission. If so, how much will the implementation and maintenance of such computer systems cost the schemes? Less or more than the existing commission and commission system cost? 2. What will the marketing agents salaries, telephone, office space ect, pension funds and so forth cost the medical schemes? Or will it be an exercise of redirecting costs? Me thinks that it will again be the poor consumer, which includes us financial planners, who will foot the bill in more ways than we realize. Thank you for your articles. Keep up the good work. Regards Jean Roux, CFP Professional
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The quest to crush the intermediary
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