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SUB CATEGORIES General  |  HIV |  Medical Schemes | 

New amendments to medical scheme act should keep medical inflation in check

28 September 2015 Graham Anderson, Profmed
Graham Anderson, Principal Officer and CEO of Profmed.

Graham Anderson, Principal Officer and CEO of Profmed.

The recent announcement by Health Minister Aaron Motsoaledi of proposed amendments to Regulation 8 of the Medical Schemes Act (MSA) suggests that patients may no longer be paid out in full for all prescribed minimum benefits (PMBs) if the amendments are adopted.

However, Graham Anderson, Principal Officer and CEO of Profmed, says the amendments are intended to ensure that medical schemes remain sustainable and that, going forward, there will also be financial benefits for medical schemes members.

Anderson says that while the proposed amendments are likely to cause anxiety among many medical scheme members, schemes will still, in fact, pay for these conditions, albeit at reduced rates.

“We believe the amendments will actually make medical schemes more sustainable and we foresee that healthcare inflation in the future should drop more in line with general consumer inflation (CPI). This is in contrast to recent years when annual healthcare inflation has typically been significantly higher than CPI. The net result will be that future annual medical scheme contribution increases should be lower than they have been in recent years, making medical scheme cover more affordable for many.”

Anderson has a wealth of knowledge on South Africa’s medical and related industries, and is keen to discuss the following talking points:

• Clarifying the definition of Prescribed Minimum Benefits (PMBs) and what these include.
• The actual amendment proposals and what they mean.
• How the proposed amendments will benefit medical schemes.
• How the proposed amendments will benefit members in general.
• The need for all stakeholders to be involved in discussions before the end of September to ensure the best possible outcome regarding the final amendments.
• Why it is important that medical aid schemes are not permitted to overcharge patients but should still remain viable.
• How the amendments would benefit low-income individuals.

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