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Viva the healthcare intermediary

01 October 2009 Linza Van Aswegen, FIA

The FIA highlights the crucial role of healthcare intermediaries, even as the proposed NHI brings more uncertainty and challenges to this dedicated segment of the broker market.

There is currently a great deal of debate around the introduction of a National Health Insurance Scheme (NHI) in South Africa. According to Wikipedia, National Health Insurance is defined as health insurance that insures a nation's population for the cost of healthcare services. An NHI scheme is usually instituted as a healthcare reform programme and is generally established by national legislation. Such schemes may be administered by the public or private sector or a combination of the two. The funding for NHI systems varies from country to country and there are a number of different models currently in place.

Widespread concern

It is with great anticipation that we await the publication of the official NHI proposal document in the public domain. The lead-up to the publication of the proposal has been filled with many rumours and assumptions which are unintentionally causing widespread concern in the healthcare industry and more specifically, in this instance, among healthcare intermediaries. Coupled with concerns around the future remuneration structure, healthcare intermediaries now also need to be mindful of the potential implications of an NHI scheme.

Valuing the role of the advisor

Although the value added by the healthcare intermediary or advisor is a reality, this must unfortunately be continuously communicated to regulators. The excellent service offered by the healthcare intermediary to the mostly confused consumer with regard to medical scheme option choices, benefits offered, complex terminology and many other technical matters, is appreciated by thousands of consumers and must therefore never be underestimated.

It's clearly not about the money

A question that comes to mind is why the misperception regarding the commission of healthcare intermediaries still prevails and constantly pops up on agendas and in the Council for Medical Schemes' Annual Report? In relation to services that the healthcare intermediary provides to the consumer, it is almost impossible to imagine how the limited compensation could incentivise an intermediary to maintain the service provided when weighed up against the costs related to time spent, travelling expenses, administration costs and the remuneration of office assistants.

So what then does incentivise healthcare intermediaries? What makes them continue to support and assist their clients? The answer is very simple: the loyalty of healthcare intermediaries towards their profession and clients drives them. Consumers rely heavily on intermediaries to steer them towards the best medical cover for their needs and budget. Choosing the right medical scheme is a significant decision, one which can have life-long implications for individuals and their families. This decision should not be taken lightly.

By and large, most consumers recognise the value of the services provided by healthcare intermediaries. From the FIA's side, we are committed to working within an affordable and accessible healthcare system in South Africa. The healthcare intermediary will continue to render a necessary, unselfish and crucial service in supporting the citizens of this country to make the correct decisions regarding medical scheme options. Viva the healthcare intermediary!

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