{"id":868356,"date":"2026-08-01T07:00:00","date_gmt":"2026-08-01T05:00:00","guid":{"rendered":"https:\/\/businesstech.co.za\/news\/?p=868356"},"modified":"2026-07-31T15:58:32","modified_gmt":"2026-07-31T13:58:32","slug":"dark-clouds-gathering-for-anyone-paying-for-medical-aid-in-south-africa","status":"publish","type":"post","link":"https:\/\/businesstech.co.za\/news\/lifestyle\/868356\/dark-clouds-gathering-for-anyone-paying-for-medical-aid-in-south-africa\/","title":{"rendered":"Dark clouds gathering for anyone paying for medical aid in South Africa"},"content":{"rendered":"\n

South Africa is facing a growing medical aid affordability crisis, driven by healthcare costs that continue to rise much faster than inflation.<\/p>\n\n\n\n

This trend is unlikely to change, as medical schemes battle rising healthcare demand and worsening economic conditions.<\/p>\n\n\n\n

Kevin Aron, Principal Officer at Medshield Medical Scheme, said South Africa’s healthcare challenges are similar to those seen globally, with lifestyle-related illnesses placing increasing pressure on healthcare systems.<\/p>\n\n\n\n

“We’re not a healthy country. Here are growing concerns of cholesterol, hypertension, hyperlipidemia, and increasingly mental health,” he said in an interview with BusinessDayTV<\/a>.<\/p>\n\n\n\n

However, Aron said South Africa’s weak economy makes the situation even more severe.<\/p>\n\n\n\n

“The South African market is just doing so badly,” he said, noting inflation of around 5%, unemployment of roughly 33%, and widespread poverty.<\/p>\n\n\n\n

\u201cAt the same time, essential services are increasing at rates well beyond inflation, with electricity tariff increases as an example.\u201d<\/p>\n\n\n\n

“What you actually have is you’ve got a major affordability problem. You’ve got an unemployment problem. You’ve got a market and industry that’s not growing,” Aron said. “That puts huge pressure on medical aids in terms of affordability.”<\/p>\n\n\n\n

He explained that more South Africans are opting for the cheapest medical aid plans because they simply cannot afford more comprehensive cover.<\/p>\n\n\n\n

“What we find is that almost R3,000 is the cap. Any option that’s above R3,000, almost nobody’s joining,” he said.<\/p>\n\n\n\n

Additionally, scheme members are increasingly suffering from chronic illnesses, resulting in higher healthcare costs.<\/p>\n\n\n\n

“They’re consuming more healthcare spend, and much of this is linked to poor diet, lack of exercise, and growing mental health challenges,\u201d Aron said. <\/p>\n\n\n\n

Aron said one of the biggest concerns is the “missing middle”\u2014working South Africans who earn too much to qualify for public healthcare but cannot comfortably afford private medical aid.<\/p>\n\n\n\n

“You have people who can’t afford anything above R3,000 a month for medical aid, and even that’s a stretch for them,” he said.<\/p>\n\n\n\n

Keeping premium increases to CPI is practically impossible<\/h2>\n\n\n
\n
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Kevin Aron, Principal Officer at Medshield Medical Scheme.<\/em><\/figcaption><\/figure><\/div>\n\n\n

As a result, these members join the lowest-cost options available, despite their healthcare needs often exceeding what those plans are designed to cover.<\/p>\n\n\n\n

“They can’t afford anything better, but their health needs are such that they actually need more than just the very minimum,” Aron said.<\/p>\n\n\n\n

He explained that this creates financial strain for medical schemes, with some members contributing around R1,700 per month while consuming roughly R3,500 in healthcare benefits.<\/p>\n\n\n\n

Aron also criticised the lack of progress on introducing low-cost medical scheme benefit options.<\/p>\n\n\n\n

He said medical schemes have repeatedly submitted proposals for plans costing between R300 and R400 per month, but the regulator has rejected them.<\/p>\n\n\n\n

“Our medical scheme, year after year, submits proposals to the Council for Medical Schemes for a low-cost benefit option, and they just get rejected outright,” he said. <\/p>\n\n\n\n

Turning to annual contribution increases, Aron said medical inflation has consistently outpaced consumer inflation for many years, making CPI-linked increases unrealistic.<\/p>\n\n\n\n

“Medical inflation, for as long as I remember, has typically been almost double CPI,” he said.<\/p>\n\n\n\n

Because medical schemes are legally required to remain financially sustainable, he said, matching the regulator’s CPI-based recommendations is “practically impossible.”<\/p>\n\n\n\n

“If you do that, you’re basically going to destroy medical schemes’ long-term sustainability,” Aron warned.<\/p>\n\n\n\n

While schemes are acutely aware of affordability pressures, Aron said they still have to ensure they remain financially viable.<\/p>\n\n\n\n

“We are all very aware of the affordability issue, and we do our absolute best to try to manage contribution increases as close to CPI as possible,” he said.<\/p>\n","protected":false},"excerpt":{"rendered":"

Keeping premium increases to CPI-based recommendations is practically impossible.<\/p>\n","protected":false},"author":92,"featured_media":860865,"comment_status":"open","ping_status":"","sticky":true,"template":"","format":"standard","meta":{"_sma_x_autopost_status":"failed","_sma_x_autopost_error":"Instagram publishing failed: Instagram returned HTTP 400: Media ID is not available","_sma_x_post_id":"2083417708335431712","_sma_facebook_post_id":"191437357620492_2163283591158707","_sma_instagram_post_id":"","_sma_x_attempts":1,"footnotes":""},"categories":[9876],"tags":[10068,17595,853],"class_list":["post-868356","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-lifestyle","tag-medical-aid","tag-medshield","tag-south-africa"],"_links":{"self":[{"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/posts\/868356","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/users\/92"}],"replies":[{"embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/comments?post=868356"}],"version-history":[{"count":1,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/posts\/868356\/revisions"}],"predecessor-version":[{"id":868366,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/posts\/868356\/revisions\/868366"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/media\/860865"}],"wp:attachment":[{"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/media?parent=868356"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/categories?post=868356"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/businesstech.co.za\/news\/wp-json\/wp\/v2\/tags?post=868356"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}