How Are Medical Aids in South Africa Doing?

The increase in subscription fees for 2017, by most of the large medical insurance corporates in South Africa, is a sign that the industry is in distress. Here we will answer the question: how are medical aids doing in South Africa.

What makes the situation even worse is the fact that the increase in fees does not tally with the benefits received. The medical insurance clientele is must settle for fewer benefits while they pay out more. The industry is mostly affected by the fact that the model and structure it runs under is very different from other insurance models. The medical insurance industry does not pool resources together to benefit members, as it is not run as a business.

Medical Insurance Increase – How Are Medical Aids Doing

How Are Medical Aids DoingThe medical insurance increase is a result of the increase in medical practitioner insurance costs as they try to guard against the rise in malpractice suits especially in specialised fields such as neurology.  As South Africans become more sophisticated. Medical clients are choosing to have certain procedures done. While doctors have become more attune to performing medical operations. Giving rise to the fee increase. Also, the fragmentation of medical services which allows components of any medical procedure for a separate charge, makes it difficult for medical insurance organisations to plan for. Let alone affix costs for any medical procedure. This lack of predictability results in fee increases as organisations tries to plan for comprehensive procedures without standardised rate cards.

More on How Are Medical Aids Doing

The Council for Medical Schemes in their 2015 trended report state that the membership base is not growing as most people are experiencing budgetary constraints. Currently, medical aid cover is not a necessity. However, there is room for change. By changing the dynamics of government involvement. Improvement in personal health care which involves changing people’s perception in the role they play in looking after their bodies. All round stakeholder involvement which is inclusive of government. Doctors and other members of the medical fraternity. Medical insurance providers and consumers in developing products. And also streamlining services to better serve the market as well as ensure their viability.

Report of the Council for Medical Schemes

In the report the Council for Medical Schemes also stated that most medical insurance schemes are operating on losses as the number of claims on medical insurance has increased over the years from 2013. The increase in claims is high by the fact that they don’t properly screen entry thus allowing anyone to join.


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