Money = Value of Health Care

Today, money equals the value of health care you will get.

Access to health care is a global phenomenon.

  • It is driven by cash.
  • also by social conditions.
  • And as well by economic conditions.
  • Also by health policies.

 

On average, health care services and products consumes about 10% of Gross Domestic Product (GDP), according to the World Health Organisation (WHO).

Although this figure varies in various countries worldwide, the cost of health care in South Africa is 9% of the GDP.

Discrepancies

Value of Health CareIn South Africa, only about 16% of the population has access to private health care.

However, payments for medical services by medical schemes accounts for over 50% of total expenditure.

It’s despite the fact that the country runs a parallel system for both private and public health care services.

In South Africa, medical schemes finance the value of health care and also direct out of pocket payments by their members.

Medical Schemes and private health care funding

The Government, together with major industry players such as medical schemes. Is trying to restructure the country’s policies to introduce affordable and value of health care for all South Africans.

However, to date, the cost of belonging to a private medical scheme remains out of the reach of most South Africans.

Medical scheme contributions have increased by above 10% since 2015.

The reasons for increasing costs

  • An increasing number of claims
    Membership figures supplied by medical schemes reveal that the average age is becoming older, and therefore requires increasing access to health care
  • This phenomenon impacts on membership growth rates
    The increasing cost of Prescribed Minimum Benefits (PMBs)
    A declining solvency ratio and increasing operating losses experienced by medical schemes

 

Out-of-pocket (OOP) payments – Value of Health Care

Out of pocket expenses by members of private medical schemes outstripped the growth rate in contributions by members.

According to the Council for Medical Schemes (CMS), members of medical schemes paid R27.2 billion in out of pocket expenses during the last financial year under review.

 

They paid 13.4% more on out of pocket expenses than the annual growth rate of contributions made to medical schemes.

In real terms, that translates into R9 billion annually spent by members of medical schemes on out of pocket expenses for medication.

With out of pocket expenses by members of medical schemes reflecting a double-digit growth rate. It is obvious that private health care is becoming increasingly less affordable to the majority of South Africa’s citizens.

 

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