Everything you need to know about medical aid schemes in South Africa right now

New data released by Stats SA in its latest General Household Survey for 2016, shows how families use medical aid schemes in South Africa.

The report revealed that the majority of people are not covered by any type of medical aid scheme –  only 17.4% belonged to a medical aid scheme in 2016.

And with half of South Africa’s health professionals catering exclusively to only 17% of the population on medical aid schemes, the entire setup is a crime against humanity and should be abolished, president of the SA Health Professions Council (SAHPC), Dr Kgosi Letlape, said recently.

Government is currently looking for a way forward on its proposed NHI programme, following the release of the NHI white paper in 2015 which said that medical aid schemes would not exist in their “current form” when NHI was rolled out.

Read: South Africa’s cheapest medical aid schemes and hospital plans in 2017

It said that government policy would see all medical aid schemes merged  into a single state-run medical aid plan.

However, last month TimesLive reported that the Department of Health appeared to make a u-turn on that plan, calling on private companies to work with government instead.

According to StatsSA, between 2002 and 2016, the percentage of individuals covered by a medical aid scheme increased from 15.9% to 17.4%.

During this time, the number of individuals who were covered by a medical aid scheme increased from 7.3 million to 9.5 million persons.

Individuals were more likely to be covered by medical aid schemes in Gauteng and Western Cape.

Percentage of individuals who are members of medical aid schemes by population group in 2016:

Here are other facts about medical aids and healthcare in South Africa:

  • The percentage of individuals in metros that were members of medical aid schemes (25.9%) exceeds the national average of 17.4%.
  • About seven in every ten (71.4%) households reported that they went to public clinics and hospitals as their first point of access when household members fell ill or got injured.
  • By comparison, a quarter (27%) of households indicated that they would go to private doctors, private clinics or hospitals.
  • Most households (92.6%) went to the nearest facility of its kind. Of those that preferred to travel further to access  health  facilities,  19.6%  presented  long  waiting  periods as a reason for securing services beyond their normal catchment areas.
  • The study found that 81.7% of households that attended public health -care facilities were either very satisfied or satisfied with the service they received compared to 97.5% of households that attended private health – care  facilities.

Read: Medical aids are a “crime against humanity”: SAHPC president

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Everything you need to know about medical aid schemes in South Africa right now