OWN CORRESPONDENT, Durban | Monday
MASSIVE price increases of between 20 and 30% will price medical aids completely out of the market, spelling the end of private sector healthcare and ushering in a national health system which the already cash-strapped government would be hard pressed to implement, experts have warned.
Jerry Bryant, the general manager of the National Independent Medical Aid Society (Nimas), was responding to reports that South African medical aid funds will announce tariff increases of between 20 and 30% for next year, amounting to a further R600m in payments during 2001.
This is in marked contrast to the six percent “across the board” increase suggested by the Board of Health Funders (BHF).
In a report in the daily Business Report newspaper, Fiona Robertson, BHF representative, said the average person could not afford increases above the consumer price index. During this year, the private sector’s medical aid contributions were estimated to be more than R30bn, she said.
Bryant blamed the price hikes on abuses by both medical aid members and healthcare professionals. Bryant said but for the rampant abuse, medical aid increases would probably have remained at between nine and 11%.
While most medical aids had budgeted for an abuse factor of between five and 10% this year, the practice had already escalated to between 15 and 20%.
Johan Wykert, the head of the healthcare division at PricewaterhouseCoopers, was quoted in Business Report as saying tariff increases would hit consumers hard next year.
He said medical aid tariffs had increased by an average 17 to 21% over the past three years, way in excess of BHF recommendations.
This year, he said he expected increases to be around 15% for new generation funds and up to 25% for the more established funds.
He said this was the only way some medical aids could protect themselves as recent legislation had ruled out more innovative savings schemes which would have compensated.
Bryant and other medical aid officials identified a host of scams which the sector had been forced to circumvent. He pointed out that because admissions were often controlled through pre-approval rules and ward and drug fees had been capped, the only way hospitals could increase income, was through keeping patients in for longer.