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Medical aids are in trouble – and you’re going to pay the price

Medical aids are in trouble – and you’re going to pay the price

While the National Treasury has introduced new regulations that will have a significant impact on the medical aid scheme industry in 2017, there are more changes coming that will also have an impact.

Treasury has introduced two regulations which will see a limit on the amount of gap cover and hospital cash-back policies you can claim, as well as the discontinuation of all primary healthcare policies.

The question on everyone’s mind is whether or not these, and other coming changes will mean customers will pay more at the end of the day.

Speaking to Business Day TV, Roshan Bhana, head of Alexander Forbes Health said that, ultimately, yes you will – at least until the industry changes.

While the demarcation regulations will certainly have an impact (and the expected conclusion of the Competition Commission’s Health Market Inquiry, as well as the expected re-introduction of the low-cost benefit option framework, will too) – the real problem is that the medical aid industry is old, and has not aged well.

The simple fact of the matter is that the medical aid industry is in trouble, with 16 of the 20 top medical aid schemes having to dip into investment funds to stay afloat during the course of 2016.

The reasons for this are varied, but it’s mostly due to three key issues, Bhana said.

  • The age profiling of medical aids is broken – there are not enough young healthy people to finance the older, ailing members like the schemes were designed to operate.
  • People are claiming more, and want access to newer drugs and treatments which medical aids need to pay for. And people in general are becoming unhealthier through their lifestyles (alcohol, tobacco and a poor diet), which has put pressure on the entire system.
  • And pricing has become unsustainable, with medical aids no longer being able to thin margins to remain competitive, while their own costs escalate.

These factors led to a tougher year for medical aid schemes, and subsequently higher than expected price increases for 2017 – which were far higher than consumer price inflation (CPI).

But this is nothing new – it’s a trend seen since 2006.

Prices will keep going up

According to Alexander Forbes, the average contribution increases for the top nine open medical schemes since 2006 have far exceeded average CPI. The margin between the level of CPI and the industry’s contribution rate was highest from 2008 to 2011.

Since 2012, the contribution increases have tended to be closer to CPI as schemes have aimed to limit increases in contributions to increase competitiveness and minimise membership losses due to affordability constraints.

According to Bhana, medical aid contributions will likely continue to increase at CPI plus 3-4% per year. This is a result of the limited ‘pool’ of contributions – consumers tend to drop to lower-cost plans, while client adoption is too slow to cover the short-fall.

This current problem highlights the affordability crossroads between clients and medical aids, Bhana said, where members are feeling the pinch of tough economic times, but schemes, by law, need to remain solvent.

Much of the higher price hikes in the past few years could even be the market correcting itself from prior years of not increasing contributions enough, he added.

The recent moves and regulations from Treasury are a step toward changes making healthcare more affordable through government’s NHI programme – but this will see medical aids having to restructure, too.

According to Bhana, one way or another the medical aid industry is going to be disrupted, though it may take 3 to 4 years for these changes to materialise – until then, the current problems are not going to go away.

You can read the full Alexander Forbes Health Diagnosis for 2016/17 here. And view Bhana’s interview on Business Day TV.

Read: Medical aids are not-for-profit: Discovery Health

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  • tshaba

    Hence, why I prefer to live life on the edge. Until I reach 30, at least.

    • BangoSkank

      Ya but then when going onto MED Aid then you get an automatic loading of anywhere between 20 and 40 % of the normal cost…. Depending how long you have not had medical aid….

      • Maestro

        You only get loaded after 35, irrespective of whether you had medical aid before this.

      • tongue in cheek

        indeed,and why? they don’t charge you 20-40% more if you don’t buy your Merc as a new model off the floor, in fact you can negotiate a better deal a few months later

        • JohnJones

          Say a person with a pre-existing classified PMB condition joins the scheme after being diagnosed. Should the scheme members pay for that person who only then started contributing towards the scheme or should the medical aid get some contribution from the person upfront? Personally, I wouldn’t be too happy if my medical aid just paid for anyone with my contributions.

          Then there is also the risk of people leaving the scheme as soon as they are healthy, only to rejoin when they are not. Penalties is a good means to stop this behaviour.

  • kid black

    the actual problem is that the whole medical industry, from drugs to doctors, are enjoying profit margins well above that of other industries and professions.

    • Konstabel Koekemoer

      Totally agree. The medical industry is totally rotten. When gap cover was introduced many specialists increased their fees up to eight times medical aid rates as they knew gap cover would pay. This obviously meant that gap cover insurance has to be limited to ensure that these schemes stay viable. And the amount of fraud committed by hospitals and doctors is absolutely staggering. Hospitals routinely add many items never used to the invoices and specialists charge for hospital bed visits where they add no value and the patient is often not even informed what the purpose of the ‘consultation’ was. I think this is the biggest reason why healthcare is becoming unaffordable.

      • Jay

        That’s my favorite. Day after operation Dr walks in while you are in the ward. “How’s things ?”. “Fine”. “Good”. Walk away and later you get that visit on your bill for R450+

        • TestSA

          lol. my experience in hospital too. One day i was billed 450 times 3 because i went to the doctors office twice just to ask about getting better.

          Thank gawd for the self administered morphine tho. I think it was R250 a hit..that was fun!

      • Jo

        I have requested a complete detailed list of all consumables and sedatives used on me for two expensive operations recently. The amounts of drugs in total, was enough to put an elephant to sleep. And the amount of bandages, swabs, and other stuff used to cover or clean a wound of about 150mm long, was enough to cover my whole body. No chance in hell to refute their claims, because one cannot prove them wrong, unless you have a witness. Its time all operations are being videofilmed, to clearly show how all those consumables and drugs were used, and also what went on during an op. Nurses and other doctors never want to refute the operating doctors’ story, for fear of victimisation, even of loosing their jobs.
        A unit of blood, or pint or 500ml of blood is being donated for free, but the hospitals charge about R15k per unit. Where did all that money go to? The blood donor organisations say you may get free blood if you donate regularly, but only when you are a private patient, while not using either a medical aid or gap cover. Very unfair situation, and horribly expensive price to charge for something which was actually obtained for free.

    • Brian MrDIY

      Yep … somebody has to pay for MBW X5’s ect.
      The real problem is that the industry can be “milked”. Somebody facing a major illness will pay whatever it takes (well most will) and the medical industry know that.

      • Jo

        Don’t be so cheap man! A Mybach with fullhouse extras costs about 3 – 4 times the price of a X5.

    • Tau’ri

      My specialist goes on holiday overseas an average of 4 times a year (always with the partner): it’s either holiday-only, or to a conference plus holiday (this paid by the medical aids, the pharmaceutical companies, the medical research institutions or what have you).
      The times I say, “Can I get the generic alternative of the meds” or “I can’t go for the MRI because I-have-no-money”, he gets all p1ssed off because I complain.
      He charges about R700-900 per 15 minutes’ visit.

  • Ga77a

    “The age profiling of medical aids is broken – there are not enough young healthy people to finance the older, ailing members like the schemes were designed to operate.”

    This is because the medical aids treat the young like trash. Why should they help.

    • BrS

      They treat everyone like that.

    • Warren Patterson

      Medical aid prices are too high for most young people.

      • Ga77a

        Never mind the cost. I was referring more about the risk profile of young people. For example people between the age of 17 and 25 are extremely likely to be in a car accident. Yet ER visits and prudent screening/tests are not covered. So if you are in a car accident, you better be prepared to lose a leg or something before you get any assistance from medical aid. Or wait until the cracked vertebrae in your neck finally gives way (see the knock on effect). Medical aids don’t work for young people and unfortunately the ‘shut up and support your elders’ mantra is not a compelling incentive.

      • Hennie

        Take out the cheapest and as you get older and earn more, go more expensive and keep yourself healthy(exercises, health foods those with low saturate fats, cut out sugar as much as possible and cut off all excess fat from your meat).

    • brz

      I’ve been a member of medical aids for my whole working life, and when I was younger I never felt that the fund treated me worse because of my age. Maybe something has changed in the meantime?

      • tongue in cheek

        yeah,wholesale greed

  • Mike Rivarola

    When you are on the operating table ask for a discount. That’s what private health care does, but public health care is even worse so at present you have the best of two evils. Capable low paid doctors emigrate so if want to retain skills you need to pay for them or chain them to a wall.

  • BrS

    I question whether people are becoming unhealthier. Additionally if something like smoking is a problem why is the South African government so hell bent on preventing smokers from switching to something safer like electronic cigarettes?

    • Tau’ri

      Because they make truckloads of cash in taxing the tobacco industry and its users. Same as with alcohol.

    • Naqsh

      What about all the stress that Zuma and his cronies give us.
      Stress is a silent killer.

  • Shaun Crosby

    I don’t like it, but what choice do I have? I have 2 kids, so there is no chance that I would even consider cancelling, so what choice do I have? Kak and betaal. Get raped for something that I pay for anyway.

    • tongue in cheek

      yeah,just maybe the smoke & mirrors crap about white colonial capital bears some considered thought

  • Johan Lewis Last

    Awwww….so sad…no more holidays and fancy euro cars? Now you can drive what we drive and stay at home too…..muwahahaha

  • Maestro

    Wait a few years all these profiteering Doctors will be begging on the side of the road to keep up on the repayments of their X5’s and Jags when Watson takes over their jobs.

    Full diagnosis and treatment in a matter of minutes in the comfort of your own home.

  • Teresa Williams

    The ANC started meddling with medical aids shortly after they got into power, and it was obvious from the start that their long-term goal was to destroy them. They’re almost there.

    • Sennen Goroshi

      I’m no ANC fan but I really don’t think they are out to get the med schemes.

      But can you please elaborate a bit on this?

      • Arthur

        Yes, the government sees the money going into private healthcare and want to put it into public health care. When that happens, you will have to pay twice, once to the government at the rate you are now paying medical aid scheme fees and then again when you have a medical crisis because as we all know, the public service is rotten. It is the stated aim of Minister Motsoaledi to have a single health service and for people to pay according to their “ability”. If you think private healthcare is expensive now, wait until the NHI comes along. Motsoaledi cares very much about the high prices of private healthcare and says so often, but he doesn’t have much to say about the rotten public health system.

        If the public health system gave decent care at low prices, people would soon make the move from private health care. But it won’t happen because public health care is a government enterprise.

        • tongue in cheek

          When that happens, you will have to pay twice, once to the government at
          the rate you are now paying medical aid scheme fees and then again when
          you have a medical crisis because as we all know, the public service is
          rotten – please elaborate ,as this statement smacks of conjecture and opinion

          • Arthur

            I am discussing the future, so conjecture, yes. Also, the evidence is long and time and space is short. However, if you look at socialised healthcare in rich OECD economies, wait times for medically necessary treatment in a good proportion of them is excessive – eg in Canada – 4+ months. Scandinavian countries, the UK, nearly as bad. During the wait time, people die or are permanently disabled. You want urgent treatment? You pay and pay and pay. Counter-evidence – Switzerland. These are rich, efficient countries. South Africa is middle-income, inefficient and corrupt. The extra money that has gone into the NHI pilots – political flagship projects – has made no difference to performance even by Motsoaledi’s admission. A short hop and a skip from that leads one to a likely outcome of NHI. Just because some government official says that everything will be OK doesn’t mean it will either.

          • tongue in cheek

            sure, your reasoning is logical,but your 1st line blames or implicates government , I do believe it has a lot to do with the greed of the med profession as a whole, as u say even in efficient 1st world countries there are delays, so it cant be only an ANC govt that’s screwing up

          • Arthur

            Yes, there is greed in the medical profession, as there is in most other businesses, no doubt about it. This usually gets sorted out elsewhere in the economy through competitive forces and regulation against collusion. Competition usually results in increased quality of service and lower prices. What the government has done is restrict competition through political interference and regulations. Scarcity has been introduced artificially. So naturally prices go up and I continue to point the finger at the government for stupid policies.

      • Teresa Williams

        Shortly after they gained power (within the first year, I think – it was all still very new), I read an article in the Cape Times or Argus (then still reasonable papers) in which the ANC laid out their views on how medical aids “should” operate. It was obvious they were clueless about how medical aids worked – also that they bore a major grudge against medical aids, as they identified them with being white, wealthy and privileged. This was before the first legislative changes they made – experts from various fields warned that their intended course would eventually destroy medical aids. Their response to this warning made it clear that they really didn’t care. I was then in my early thirties – I figured that I would pay into a medical aid for 20 years or so, then just when I started actually needing it, it would become prohibitively expensive and offer less and less in return – so I never joined a medical aid. Various analysts are now warning that the ANC’s policies (the whole NHI scheme) will lead to the end of private health insurance, which in turn will effectively lead to the collapse of private health care in SA. (Only the most expensive of the most highly specialised services for the filthy rich would survive.) Anthea Jeffery was one of those commenting, if I remember correctly.

    • Ray Mulder

      Total uniformed bs… and I don’t even vote ANC… keep it real.

      • tongue in cheek

        yup, conjecture & opinion. maybe big Pharma and med pro’s need taking down a peg or 6

  • shelly

    I cancelled my medical aid at work for me and my mom cs it was way too much, sitting here at groot schuur emergency unit for myself I’m so sorry I did,

    • shelly

      Please guys if you can afford it please I beg you keep your medical aid today I have seen first hand the horrors of public hospitals, a patient was laying on the dirty floor where cockroaches were running around and the nurse’s and staff literally just stepped over her eventually a docter sore her and helped her immediately

      • Wurnman

        Yeah, i lost a friend over their poor service… unfortunately there’s no way one could prove it was negligence from their side.

        • shelly

          Sorry for your loss, even if you could prove it was their fault they just don’t care

  • Darren Grant Carter

    I blame the pharmaceutical industry and medical practices for taking unfair advantage of those on medical aid. I recently acquired a pair of spectacles, and having done my research and price comparisons beforehand, I noticed a trend where one’s eye test costs significantly more when claiming through a medical aid as opposed to paying cash, in once example, a cash test was R170 whereas my medical aid would have been ripped R400 for the same, that is more than 130% markup just for claiming from my medical aid. I recall a similar scenario a few years back with a psychologist. In my mind, this is pure extortion, and more than half the problem. This sort of behavior is abusive to consumers. Health is a NEED, not a luxury upon which practitioners should be profiting so grossly. I understand businesses need to make money, but this is just abuse of the system.

    • brz

      Very well put.

      Medical aids will be in a much better position if that misuse can be eradicated. And of course members themselves must use their medical aid benefits in a disciplined way so as to save the funds and themselves money. I only see one specialist for the one chronic condition I have. I’ve not been to a general practitioner for more than a decade.

      • Herman Ellis

        Having read this far there are valid points from all sides. Especially the point in the article about skewed age profiles. I am 66 years old and in good health. We pay approximately R6000 per month for medical aid or R72 000 per annum, but MA refuse to cover all but one of my chronic medication. Even so, the one they do cover has to be a generic. There is an elephant in the room which nobody has addressed thus far – there is no “carry-over” of my unspent funds from year to year! Probably an annual amount of R70 000 which I have paid for many years and will never see again. Now let us say I might require a bypass or something at age 72 – 75. I will be limited to my annual benefit schedule! Or I simply get fed-up at 70 and resign from MA – wouldn’t they just LOVE that!

        • brz

          The reason why there is no carry over of “unspent” funds of course is that a medical fund is nothing more than medical insurance and works the same way as any insurance scheme: the people who do not claim subsidises those who do claim.

          If you’d known at age 20 that you’d be healthy at 66, of course it would have been better to save your money in your own private fund than being a member of a medical aid scheme.

  • TestSA


  • Wurnman

    Medical industry is fast becoming like government… exploit the populace

    • Ray Mulder

      Not fast becoming… They are already.

  • Ace of Spades

    The whole system needs to be changed – everyone should have access to basic medical aid – at the moment its just a rip off and most can not afford it!

    • brz

      Well, everyone without medical aid does have access to medical services at clinics and state hospitals, but of course the present government is running that system into the ground through pathetic management.

  • Simbie

    Medical specialists are way too greedy. An anaesthetist charged us R905.00 just to travel +- 5km to attend my wife’s op. An eye specialist charged us R4000.00 for a twenty minute ‘test’ on a machine – medical aid only paid R1600.00 because that’s about a fair and reasonable price! And the first thing a specialist will ask is ‘do you have gap cover?” when it is none of their business to do so!

    • Rixxi

      I’m not saying that medical professionals aren’t greedy – but have you taken your dog to a vet recently?

      • Simbie

        Just got back from the vet with our 16 year-old cat. We changed vets recently and are getting a far better service at +- 20% less than before. Additionally, our ‘new’ vet has put our cat on ‘chronic’ which means we only pay the medicinal cost and no consultation fees! What a pleasant surprise – they are out there, you just have to find them! For my wife to get her ‘chronic’ medication for her eye problem, she has to undergo the R4000.00 test every six months! That’s downright extortion!

  • Joseph Tettey

    Let’s change our lifestyle and win. Most of health issues are lifestyle . Change our habits and you may not see a doctor for years. That extra indulgence can cost you a lot..

    • brz

      Very true, but humankind likes the comfortable, indulging lifestyle.

    • Nit Wit

      I disagree. Medical aid is technically not health insurance but that’s how it’s used.
      People are scared (for good reason) that if they have an vehicle accident or get a serious illness like cancer that they’ll die if they need to be treated in a public hospital. I have a hospital plan for the above but in practice it’s really an insurance plan to cover risk.
      The entire private medical aid scheme is on an unsustainable path. With the continual increases above CPI it will get to the point where one works just to have medial cover.
      As much as I despise how government get their fingers into things and mess them up, I think NHI actually may be what is needed to shake the industry up. I’d cancel my Discovery hospital plan in a heart beat.

    • sleepingdog

      It’s a toss up between physical and mental health then. My ‘indulgences’ keep me from going off the deep end…

  • Thepaxster

    I don’t live a particularly healthy lifestyle, I smoke and drink and avoid the gym, yet I only see the doc once every couple of years. The only reason I have a medical aid is for my child. And God knows, you can’t just take one out for a child, that would be ridiculous.

    • brz

      I don’t know how old you are, but many people are glad to have medical aid when they get older and health problems start appearing.

      • Thepaxster

        I am only 35. And my family doesn’t live particularly long mid 50’s is average so I won’t be too much of a tax on medical. Lol, and that includes the healthy ones. On my salary medical aid takes up more than 15%, so it is a bit of a grudge purchase, since it isn’t included with my company. But I agree with you though, although it has not once paid for my medication. It is very important for youngsters with having to go to creche.

  • DumbSA

    no actual mention of the cost of medical practice, you know doctors, surgeons, hospitals, drugs etc. like the below post says.

  • Ray Mulder

    Unfortunately it has been a long time since doctors actually became doctors to help people. They are more interested in the money… and, ‘The Hippocratic Oath’ has become the ‘Hypocritical Oath’. Yes…I know there are some nice and good doctors out there, but they are rarely interested in you if you cannot pay the huge prices they charge you, and all the tests which need to be done just to make sure they don’t make a mistake in the diagnosis… then they can say…”well the test said so”. The standard prescription of antibiotics and cough mixture they learnt at varsity seems to be all they need for 80% of the day to go off well… maybe we just need a good nurse to give us the prescription?…but no, we can’t do that because then the learned doctors won’t make a fortune, and the medical authority won’t be able to stick together and bs everyone about how much they know about the human body… when in fact they know very little beyond what anyone can lookup with Google.
    Now lets move on to the guys who make the drugs and everything else which we pay an arm an a leg for to stay alive… like the ripoff price of private hospitals…etc etc.
    The entire medical system is based on fear of death, and it is much like an organised torture system… “if you have enough money we can save you from torture and agonizing pain” … else, “sorry mate go home and die”
    If you think I am being cynical and am uninformed, then just take a day off one day and visit a government clinic to see the real state of the medical world… and have a look at the price of medical aids… and imagine you were in the same predicament as many many people are…. In the government clinics there are people queued up around the block, while the fancy doctors sit in their air conditioned rooms paid for by the people in the waiting room with big fat cheques in their pockets lines up to pay.

    • Naqsh

      My doctor is a bit pricey i must admit – but if you go back to him within 7 days with no improvement – he doesnt charge you.
      He gives good medication (or so my wife – the self-taught pharmacist – says). But most of it isnt unaffordable.

      On the flip side I have been to doctors who ask me whats wrong – i tell them its the flu. They look at my throat, take my pressure and check my chest and then tell me its the flu – bang! 500 bucks. like wtf?

  • chacma

    Find out which hospitals charge medical aid rates and specialists based at that hospital also limited to medical aid rates. Cape town has Vincent Palotti.
    Then find out if your dentist sends your bill to your medical aid and if he is contracted to medical aid.
    Dentwise a franchise and certain Fish Hoek dentists are contracted to Gems and the bill goes straight to the medical aid at medical aid rates.
    Medicross doctors send your bill direct to your medical aid.
    Certain medical aids will not approve of say Constantia Hospital but do approve of Kingsberry and a new hospital in Tokai.
    Tell your doctor this if you are being sent to hospital.
    One more point always take the most expensive option you can afford when taking medical aid as it will prove less costly in the long run.

  • chacma

    You do not hear people complaining about how much an airline pilot is paid when they are flying you through bad turbulence or when you arrive safely at your destination.
    It takes 7 years to train to be captain of a 747, it also takes about the same to train as a medical Doctor but yet you complain about the price they charge to save your precious life.
    Only the best doctors become specialists, you wouldn’t want an idiot working on you now would you. A specialist in their field takes 8 or 9 years of study in total before they can call themselves a specialist in their field.
    Be thankful that they have chosen to study in their field to save your life.
    Medical conferences are not all just party party as some think.
    Doctors , like all professionals have to update their skills to keep their license to practice , do you in your profession ?
    Oh me, you ask , am i a doctor or in the medical field ?
    No, was a tour guide, before that worked in FMCG for 33 years.
    Why the case for doctors, on 3 occasions some of these highly paid , overworked medical people saved my life,

    • Ray Mulder

      You have a choice to go by car or by bus and avoid the expensive airline pilot.

    • Madimetsha

      we appreciate their efforts and skills, but they are ripping people off, and this questions their ethics as professionals.

      Take out a tooth cash price R150-00
      Take out same tooth medical aid price R600-00

      see what I mean?

    • ToothyGrinn

      As soon as someone starts charging you to save your life, it becomes blackmail.
      Doctors should work for a salary, If what you say is true and a doctor cannot solve my problem then surely he/she should not get paid.
      After all that’s how it would work if I took in my broken microwave for repair.
      No repair, no payment.

      Also Pilots earn a salary, they do not charge us to fly us to a destination.
      It should be the same for doctors.

      • Dale

        It is the same for doctors… in public service.

        Private is a case of the hospital is a mall, and each doctor is his own corporation with his own overheads and staffing costs.

    • Simon Orford

      I think it’s fair to say that all professionals have to continually upskill. My wife who is a structural technician designs the structural aspects of buildings. Hundreds can die if she’s gets it wrong. She is required to belong to various associations at a significant cost and to attend courses etc to be allowed to continue to practice. She earns a pittance compared to doctors. Certain professions earn unreasonably more than others but it dosent make it right

    • Jo

      A 747 pilot or latest replacement model, gets in one month what a doctor gets in only a few days. Sometimes only one day for the doctor. Yet a pilot is holding the lives of maybe a few 100 people in his hand per flight, or a few 1000 per month, while a doctor only have one life at a time in his hand.
      An anaesthetist gets paid at least 60% of what a doctor gets paid per operation. While a machine could be used to do the same job, possibly even better than a person. A hospital should have only 1 or 2 anaesthetists on standby, just for in case the machine encounters something that it wasn’t designed for. That will make operations also much cheaper. There were days many years ago, when the operating doctor used his colleague to assist with anaesthetics, at a rate many times cheaper than a specialist anaesthetist. Which is much better, since he can keep an eye on the operating doctor as well for procedural purposes. That will help in the ops being covered by 2 doctors, resulting in many times less insurance costs.

  • Schalk Spies

    The whole medical aid and care industry is one huge con designed to fleece the general public.
    I recently landed in the clutches op a so-called specialist that shouldn’t even be allowed to work on 10+ year old car!
    This dumped me into the healthcare system with disastrous consequences.
    It led to a final bill of over 200 K on a procedure that should have cost less than 40 and in the process I nearly lost one of my legs….
    And where did the largest portion of this whole process go to……..the “private” Mediclinic group @ 82 K for 2 x operations and a 5 day stay….
    Further investigation of their annual financial statements made some interesting reading because close to 23% of their operating expenses go to non medical essentials like administration and actuarial services…!
    The pinstripes with the fancy cars that sit and calculate how best to fleece the medical aids and private patients, like me, so they can sell their company, at a huge profit to Mid-east petro-dollars so they can buy another toy or that condo in Malibu or Plet for their annual “rest and recuperation” after an “exhausting year of plunder”
    No wonder the government tried to investigate and change things, a pity they could only curb the actual professionals that provide the care
    This worked out to only 30 K for 2 x specialists (including the 1st idiot which I refuse to pay) and 2 x anesthetists, or in lay-mans terms, only 14% of the final cost.
    Who is the most important, the specialist or the pinstripe..?
    Screwed up priorities, that simple.
    The Mediclinic MRI scan alone was a whopping 10 K for a 20 min scan….if it works just 6 hrs a day, 20 days a month, it equates to a whopping 180 K a month or R 2.16 MILLION a year…….and the machine I was in was at least 10 years old so it has generated; at their rates; 22 MILLION RAND in a decade.
    But I digress….
    The Mediclinic lab tests came to another nearly 15 K, this on top of of the 82 K for a total of 107 K.
    Breaking this down, we know where to lay the blame….
    With our shower-head President and all his Zupta cronies that pigs out on the public trough with impunity from even the Law and Courts of the land, we live in the 3rd world, as much as we try to aspire to 1st world standards…a truism.
    So as much as it irks, what else can we expect?
    If you want good, proper care…K*k and betaal, its how our system works.
    That’s why my son is studying medicine…to go practice elsewhere hopefully.
    Cry the beloved country..

  • humorouskakalldis

    Its amazing how the government wants to implement cheaper medical care. I guess by reducing the pass marks it allows any idiot to become a specialist and then accept a salary that any idiot would be happy with. I can just imagine what’s gonna happen when we go into a public hospital in the near future. Guys, just nite the bullet and try to keep your medical aid, cos that way at least u won’t have to face and experience the discomfort and hu.iliation of being treated by glorified interns that have contributed to burning books and educational institutions

  • ObviousJoe

    Unfortunately the only way to cope here is to drop to a lower plan (just in hospital), which is what I’m going to do, because if I can go 4 months without having to go to the doctor and just save a third of my current monthly premium instead, I’ll be covered in exactly the same way a full year of full premium would cost.

    So avoiding a doc for a year, will be 3 years doctor cover right there… without medical and without gap cover (and then using a doc at 200% rates and not 500% like most lately)

  • Fix public care! I’ve been receiving treatment at the clinic for the last two months odd. In that time, the level of service has been hit and miss. The one time I waited a week for lab results only to be told they misplaced them. They pleaded with me to retake and they gave me my results in 3 days. See, they can provide a good service they just don’t.

  • Rach

    People it is simple. Phone around for the fee the doctor will charge and go to the one that charges what you are prepared to pay. I know some fab doctors who do not charge an arm and a leg and are brilliant doctors and specialists. If you pay cash or c/card you do get a discount then claim back from your medical aid. Your funds last a little longer this way. Some of us can some can’t but if you started working and put even just R50.00 a month away without touching it no matter how much you wanted that smoke or beer you would have the back up funds to do this by the time you start getting ill. I certainly won’t be using NHS in SA – the government hospitals and health overall in SA has been screwed up by Dlamini Zuma – can any of you see it coming right with more funds pumped into it? And the education dept isn’t far behind screwed up by Angie. Unfortunately our hard earned income has to go a long way with the high cost of food and veg not to mention school fees and school requirements – but thats another subject for another time. Sterkte mense!

  • ToothyGrinn

    “The age profiling of medical aids is broken – there are not enough young healthy people to finance the older, ailing members like the schemes were designed to operate.”

    That’s because medical aids charge too much and as a result have fewer healthy young people contributing to the fund.
    It’s the old South African mentality of “Let’s milk for what they got!!” and then they wonder why sales are down.

    • Eugene

      Problem is they are legally require to remain solvent while at the same time covering a growing list of PMBs. This coupled with the extortion of the medical industry, means they have to continually raise their rates.
      It’s those damn “private healthcare professionals” who you should be blaming

  • Ray Mulder

    90% of day to day illnesses, which people rush to the doctor for, will be gone in a week without the help of a doctor. Use common sense and natural things like oranges and lemons.

    • Naqsh

      Problem is that you have to be back at work in a day or have a doctors letter.

  • Dash…

    I don’t think it should be legal for doctors or health care facilities to ask which plan you are on. This is ludicrous, it means that they charge you according to what your medical is willing to pay. Ofc medical aids are going to lose money when that happens. There should be one price for all, the current way is unsustainable and if used in any other industry would not be allowed.

  • Eugene

    Honestly this is all caused by doctors and the rest of the medical industry. Medical aids are falling victim to their extortion and simply passing along the costs to the consumers. The out of pocket rates on most things in the medical industry are way less than what doctors and the rest charge the schemes. They are going to break the system with their greed and we are going to pay for it with our money and our lives

  • ArnoVermeulen

    Everybody in this coversation blaming the medical industry are total idiots and have no clue how most pharmacies etc fight to keep there doors open due to legislation and single exit price “fixed cost” You guys obvoisly not in the industry… I can say the exact same for other industries like motor repair shops etc.. But they aswell have bills to pay.. Think again😉

    • humorouskakalldis

      Hey mam, I think you missed the ball here. How could I have dropped outa college if I already dropped outs high school? Eish, ….

  • Lindo

    And the ripping off continues unabated

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