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More choice in an increasingly complex landscape – (part 1)

GTC Medical Aid Survey 2018 – More choice in an increasingly complex landscape

GTC, leading wealth and financial advisory firm, released the 2018 Medical Aid Survey recently. The survey compares local medical aid schemes on cost to members across various levels of cover. This comes in the midst of renewed emphasis on the South African health sector with the recent focus on the National Health Insurance (NHI) Bill, the Medical Schemes Amendment Bill as well as the Health Market Inquiry preliminary report.

According to a news release on the survey results there has been a significant growth in the number of medical schemes performing well across all sections of the medical aid spectrum. Whilst this means that members get more choice, it also makes the landscape increasingly complex.

At a media roundtable releasing the GTC 2018 Medical Aid Survey (MAS) Jill Larkan, Head of Healthcare Consulting of GTC welcomed the greater diversity.

The survey analyses and rates medical aid schemes according to a standardised comparison and ranks the choices available to members.

When analysed purely in terms of premiums – the survey’s micro ranking – Fedhealth emerged as the medical aid which held the most top positions across all the classifications. Discovery was ranked in first place for the survey’s macro rankings, which analyses a medical aid’s overall ‘health’ and longevity in terms of factors such as its solvency level, membership growth, net healthcare result and member satisfaction. When combining both the GTC micro and macro rankings, Discovery claimed the highest number of top positions among all categories – for the second consecutive year since the survey’s release eight years ago.

“While the overall results appear to tell a similar story to last year, it is encouraging – when drilling down into the details – to see such a variety of participants offering options across all sub-sections of the medical aid spectrum, meaning consumers can confidently access more schemes and plans offering private healthcare, and so decrease the burden on the government. In the past, the larger and more established companies tended to dominate the majority of the categories,” she says.

Larkan ascribes this to companies becoming more innovative in their offerings in an attempt to differentiate themselves.

“We always welcome more competition among schemes, as it indicates a growing market and more variety for members with changing healthcare needs. However, this does add more complexity to a healthcare arena that is already difficult to navigate for the majority of members.”

According to Larkan, this year’s survey proved again that the medical aid market continues to be a complicated space to navigate.

“What is worrisome is that many of the plans attempt to attract members concerned with the high cost of healthcare, by offering ‘manageable premiums’, perceived to be of good value, which in fact have far fewer benefits than their more ‘traditional’ counterparts. It is now more important than ever for members not only to look at price – which remains the most important consideration for many members under ever increasing financial strain – whilst also considering which benefits they are forfeiting for their lower premium,” she says.

This year’s survey includes a comparison of average annual salary increases over ten years – according to the 21st Century ‘The South African Trends Report 2017’ – against average annual medical aid premium increases since 2006.

“Over this period, medical aid premiums increased by 104.87% cumulatively, while salaries increased by 80.20%, which clearly demonstrates the pressure that consumers have been under in trying to keep up with healthcare costs,” says Larkan.

The MAS analyses plans based on a number of classifications, namely entry level, hospital, saver and comprehensive plans. Some of the entry level plans are salary-based and only cover prescribed minimum benefits (PMBs) whilst others restrict hospitalisation to state facilities.

“These entry level plans are a good option for members who are new to the private healthcare market and are happy to have a combination of a primary healthcare and hospital plan. Those members who expect slightly more comprehensive coverage but limit themselves to the cheaper plans, as a means to minimising cost, will be disappointed when they find out that they are not covered for a number of procedures they might have expected. In healthcare, the mantra ‘you get what you pay for’ could not be more apt.”

In part 2 we focus on feedback on member experience and the ranking of the medical schemes.

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