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11 Aug 2009 11:44
South Africa’s first recession in 17 years could be to blame for an increasing number of stress-related illnesses, Pro Sano Medical Scheme said on Tuesday.
“Stress-related conditions could well be linked to the recession and are being seen across the board, in people of all ages and income levels,” said Dr James Arens, clinical operations executive of Pro Sano Medical Scheme.
“Quite simply, it seems as though money worries and job insecurity are making people sicker and leading to increased hospitalisation and medical treatment,” he said.
Arens said a number of medical schemes had reported a significant change in the usual claims patterns and it appeared medical aid claims were on the increase.
“Claims expenditure in the first half of the year are usually much less than what we’ve seen this year,” he said.
“We normally notice peaks around May, June and July linked to winter ailments,” he said.
However, claims received in the first part of 2009 were almost as high as mid-year claims, which was “worrying”, Arens said.
He said the medical scheme had noted a significant increase in serious ailments requiring hospitalisation, such as cardiovascular illness—hypertension, strokes and heart attacks—as well as psychiatric conditions such as depression and other mental disorders.
These stress-related conditions could well be linked to the recession, he said.
Arens said schemes had also noticed an increase in the number of people joining the scheme, undergoing expensive hospital procedures and then cancelling their medical scheme membership soon afterwards.
However, patients were not the only ones feeling the pinch.
According to Arens, schemes were also noticing a marked increase in fraudulent claims.
“In these cases, what often happens is that a practitioner loads their bill, so that a legitimate procedure is padded with all sorts of additional codes, which patients often do not understand or think to question ... we see this happening all the time.”
He said hospitals run as businesses were also feeling increased pressure to show profits and keep their shareholders happy.
“There are many cases where the length of a hospital stay has increased by one or two days—for no apparent reason, adding thousands of rands to patient and medical scheme bills,” he said.—Sapa
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