- Medical schemes have long been an issue for many South Africans who can't afford them
- Health minister Aaron Motsoaledi recently informed South Africa that changes will be made to benefit more South Africans
- There are 10 very important changes that have been made from taking away brokers to making fake schemes illegal
On the 21st of June, South Africa's health minister, Aaron Motsoaledi, shared the National Health Insurance Bill and the Medical Schemes Amendment Bill with the country.
According to Motsoaledi, the new bills will give more South Africans access to medical healthcare through National Health Insurance (NHI).
BusinessTech reports that Motsoaledi stated that medical schemes hold on to almost R60 billion in reserve that remains unused.
Motsoaledi also added that clients of medical scheme pay more than R2 billion to brokers without even knowing it.
Here are the 10 changes that will be made to the Medical Schemes Act:
No more co-payments
There will no longer be any co-payments which mean that medical schemes will be expected to pay the full amount that is charged to their patients.
Motsoaledi stated that many people will be upset by this change. People will see it as a way to destroy the medical sector, but he insists that the decision was well thought through.
No more brokers
Motsoaledi feels that the role of brokers are questionable as the number of South Africans who joined medical schemes in the last 15 years has remained static. Brokers will, therefore, be declared abolished.
South Africans have unknowingly been paying R2.2 billion to brokers.
No more prescribed minimum benefits
The third change made is the elimination of prescribed minimum benefits. These are replaced with more comprehensive benefits.
Added benefits that will include screening services, vaccinations and family planning.
More equal benefit options
This change will ensure that clients benefit with every option given my the medical scheme. Any options offered by the medical aid must first be approved by the Registrar of the Council of Medical Schemes.
Taking on ‘fake’ medical schemes
It will now be an offence for any business to call itself a medical scheme if it does not meet the requirements under the Act.
Motsoaledi stated that is act takes on the many health plans that flooded the medical aid world. Many of these schemes are not registered.
Implementing a central beneficiary registry
The behaviour of South Africans when they choose a medical scheme will be better understood by the Registrar of Medical Schemes with the registry.
Information such as location, age, and diseases will be noted, but personal information will remain private.
Income cross-subsidisation model
This change could be the most important one, though it is still unclear exactly how it will be implemented.
Motsoaledi wants medical aids to make sure that the young help sponsor the old, the rich help sponsor the poor and the healthy help to sponsor the sick.
At the present moment we want to argue very strongly that it is the other way round. The present contribution table charges lower and higher-income patients the same amount for benefits, which is not the way the world should be.
Medical Aids must pass savings on to clients
Motsoaledi stated that medical schemes make their clients go to specific service providers to save money, but the clients don't save anything. The savings currently go to the schemes, which he believes is wrong.
These savings should now be beneficial to clients in the form of premium reductions.
Currently, when a person joins a medical scheme, there is a "waiting period" in which a client must pay before benefiting from the medical scheme. However, if a person cancels membership, they are often still forced to pay.
This will be ended, as well as the penalties given to people who joins a medical scheme later in life.
Monitoring of medical aid schemes
Thanks to this change, anyone wanting to become a CEO of a medical aid scheme or join a board, must now meet minimum education requirements.
These changes are bound to shake up the medical scheme world.
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