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Low Cost Benefit Options and Demarcation – BHF also criticises announcements

The announcement by the Council for Medical Schemes (CMS) that no primary health insurance plans and low-cost benefit packages would be permitted after March 2021 was met by severe criticism from the industry.

The Board of Healthcare Funders (BHF) is the latest body to raise its voice in protest. In a recent broadcast interview, Cathy Mohlahlana of News@Prime was joined by Charlton Murove, head of research of BHF.

Murove points out that although they have not joined the boycott called by the Health Care Stakeholders Forum, they share some of the sentiments and would like to further engage with the CMS to resolve some of the issues. He shared that CMS’s Circulars 80 and 82 of 2019 announced the scrapping both the Low Cost Benefit Options (LCBOs) and the Demarcation Exemption Framework. The biggest issue for them is that it does not introduce an alternative to the scrapping of the Demarcation products which currently has 500 000 beneficiaries covered under the product. An alternative would have been the LCBO, an option that was introduced in 2017. With the latest announcement, the CMS has acted against this 2017 agreed principle. The transition of the 500 000 beneficiaries to a LCBO would have introduced them to the medical scheme environment.

According to Murove the boycott is specifically against the engagement sessions of the CMS. Although they are promoting engagement they have not changed the announcements as per the released circulars and the discontinuation of these products still stand. “Why are you still engaging? What are you trying to achieve?” Murove questions. He further also questions what the CMS is saying in the media as it does not align with what is on paper, i.e. the circulars.

On the question whether this announcement by the CMS is not a step towards the introduction and roll out of NHI, he mentioned that it will add a further burden on the already over-burdened state facilities. “If people are willing to contribute to health-care, you rather let them contribute and receive health-care, rather than take away voluntary funding, especially in an already suffering SA economy,” he further shares.

Murove further mentions that he feels that there was no rationale for the CMS’s decision. He believes that their decision was purely reactive as the circulars were published without any consultation, a step that any regulatory body normally take with industry members.

Click here to view and listen to the interview.

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