HFA News

Minister of Cooperative Governance and Traditional Affairs (Cogta) Nkosazana Dlamini-Zuma has published a directive which outline South Africa’s new lockdown rules

Cape Town – A further 93 Covid-19-related deaths were reported on Monday – six from KwaZulu-Natal, 11 from Mpumalanga, 16 from the Free State, 37 from the Western Cape and 23 from the Eastern Cape – Health Minister Zweli Mkhize said.

President Cyril Ramaphosa says the global Covid-19 pandemic crisis has starkly highlighted the value of universal health coverage in responding to health emergencies, and the need for robust health systems to save lives.

In our previous article, we said that the Covid-19 pandemic is intensifying locally and demands on the healthcare system are increasing along with pressure on scarce healthcare resources. It seems certain that the public healthcare system, which ordinarily provides care for 80% of the population, will be overwhelmed by this crisis.

One week into South Africa's nationwide lockdown to prevent the spread of coronavirus, and it is tempting - dangerously tempting - to breathe a sigh of relief.

Fellow South Africans,

I am addressing you this evening on a matter of great national importance.

The world is facing a medical emergency far graver than what we have experienced in over a century. The World Health Organisation has declared the coronavirus outbreak as a global pandemic. There are now more than 162 000 people who have tested positive for the coronavirus across the globe. Given the scale and the speed at which the virus is spreading, it is now clear that no country is immune from the disease or will be spared its severe impact.

The mortality rate of COVID-19 in South Africa will depend on the actions of individual citizens, according to healthcare actuary Shivani Ranchod. Ranchod is a member of the Actuarial Society of South Africa and CEO of Percept Actuaries and Consultants.

The South African government has encouraged ‘social distancing’ as it grapples with coronavirus pandemic, and the official recommendations published by the Department of Health state that people should avoid ‘non-essential workers’ in their homes.

One of the big issues around Covid-19 worldwide, has been testing. Cost has been a huge factor, especially for cash strapped South Africans. Those with medical aid probably hope they are covered, but it is not that simple.

In a tough budget that has seen the Treasury cutting spending across government departments, not even health has been spared the axe.

A proposal to cut the state's wage bill by R160.2 billion over three years as Treasury warns of ever-rising debt repayment costs, was one of the key announcements in the 2020 Budget.

Medical tax credits that medical scheme members enjoy have been increased slightly in this year’s Budget, but the increase is a mere 2.8%, amounting to R6 or R9 for each person whose medical contributions you are paying

The Council for Medical Schemes (CMS) has published a new circular in which it prohibits South African medical aids from offering Low-Cost Benefit Options (LCBO) to low-income market segments.

Discovery is targeting 500 000 insurance clients in South Africa to take regular surveys on their mental health in an extension of a programme which rewards “good” behaviours.

Bonitas is just one of a number of medical aid schemes offering an enhanced menu of benefits for members for next year, writes Lynette Dicey

One of the challenges facing medical schemes is that, in the past few years, the average age of beneficiaries has increased. Older members typically claim more from their medical schemes, which impacts the contributions charged, and results in higher annual contribution increases. 

With about 75 medical schemes available in SA, and numerous benefit options to choose from, selecting a medical scheme and an appropriate plan can be somewhat bewildering.

Scheme’s members able to chose from a number of plans to suit their needs

Fedhealth has created a medical aid solution that puts control, flexibility and affordability back into the hands of members via a number of mechanisms.

INTERNATIONAL MEDICAL INSURANCE PLANS ARE ALSO AVAILABLE WHICH TEND TO BE POPULAR WITH EXPATS AROUND THE WORLD

There’s a difference between medical aids which fall under the umbrella body of the Council of Medical Schemes and other medical cover such as medical insurance.

What is unclear is the precise role of medical schemes under this service

THE WEALTH OF DATA, EXPERIENCE AND EXPERTISE THAT EXISTS IN THE PRIVATE SECTOR SHOULD BE BUILT ON RATHER THAN DISCARDED.

SA operates a two-tiered healthcare system: a free public healthcare sector and an expensive, but better quality, private sector.

There are 75 medical schemes in SA, consisting of both open and restricted medical schemes. Medical schemes are regulated by the Council for Medical Schemes, a statutory body which provides regulatory supervision of private health financing through medical schemes.

Typically the most common medical expense shortfalls relate to hospital admissions.

In these instances the member may have to pay the difference between what their specialist charged and what their scheme paid for their inhospital treatment, or for consultations and treatment in the period prior to and after the admission, according to Deon Kotze, head of Research and Development at Discovery Health, the administrator of Discovery Health Medical Scheme.

Digital innovations have the potential to lower barriers to access high-quality private healthcare

THE INTENTION BEHIND SMARTCARE IS BASED PURELY ON ACCESS AND CONVENIENCE WITH A GOOD PRICING BENEFIT

Sophisticated benefit design that puts medical scheme members in control of their healthcare while providing one of the strongest value propositions in the market has enabled Health Squared Medical Scheme, the result of a merger between Resolution Health and Spectramed medical schemes, to implement single digit contribution increases and an array of benefit enhancements for the coming yea

In our review of the South African private healthcare market we found that it is characterised by high and rising costs of healthcare and medical scheme cover, and significant overutilization without stakeholders having been able to demonstrate associated improvements in health outcomes.

South Africa's private healthcare sector is not competitive enough, with only a few dominant players, the Healthcare Market Inquiry has found. 

South Africans are paying more for private healthcare than ever before. But forking over more cash for more — and often unnecessary — care, isn't paying off for consumers,  a five-year investigation by the Competition Commission shows.  

The Competition Commission has backed down on its initial recommendation of divestiture for Netcare, Life Healthcare and Mediclinic

The Competition Commission has published the findings of its national health market inquiry, uncovering several major problems with South Africa’s private medical aid schemes and hospitals.

The Gauteng Department of Health has revealed that at least 12 of the province's hospitals do not have permanent chief executive officers. The province has 32 public hospitals under the department's authority. 

The Competition Commission has laid the blame for the rising cost of private healthcare at the feet of the national health department.

The Gauteng Department of Health has revealed that at least 12 of the province's hospitals do not have permanent chief executive officers. The province has 32 public hospitals under the department's authority.

Trade and Industry Minister Ebrahim Patel said the inquiry into private healthcare had recommended a standard medical aid package that would make it easier for consumers to compare services.

Government’s National Health Insurance (NHI) Bill is not the only roadmap to quality healthcare for all in South Africa. The Health Market Inquiry into the private healthcare sector report points the way toward an alternative, possibly more effective, approach

The average medical aid user does not know that brokers charge monthly fees hidden in the regular premiums they pay. A report by the Competition Commission found that medical practitioners are subject to little regulation.

Medical schemes are largely failing to impress consumers when it comes to customer satisfaction. According to the South African Customer Satisfaction Index, conducted by Consulta, there is no one scheme that has clearly differentiated itself in terms of customer satisfaction.

Business Unity SA’s concerns about NHI extend beyond investor sentiment, as its members are affected by any changes to the health system

One of SA's most anticipated pieces of legislation, the National Health Insurance (NHI) Bill, was tabled more than two weeks ago but instead of providing relief it has caused confusion and speculation about the future of health care in the country.

PRETORIA - A proposed move to universal health coverage in South Africa will be rolled out in stages as the budget improves, a senior presidential aide said, forecasting the landmark reform would cost R33bn  per year by 2025/26.

What are the politics of the controversial NHI? What specific concerns do people of South Africa have with the NHI Bill and what it will take for them to find common ground with proponents of the proposal?

Di McIntyre, emeritus professor, University of Cape Town : Ultimately, we will all pay into a central health fund according to our means, receive medical treatment according to our needs - and sleep better at night

The recent tabling in Parliament of the controversial National Health Insurance (NHI) Bill sent ripples of panic through the medical and financial fraternities, with Discovery’s share price taking a dive.

When the NHI is implemented in 2026, the lives of medical schemes, their employees and their brokers will be in for a lot of changes. FAnews posed a few questions to Jeremy Yatt, Principal Officer of Fedhealth, who raised several concerns about the NHI.

The SA Private Practitioners’ Forum says many doctors bill incorrectly out of ignorance rather than because they intend to commit fraud.

The inquiry began work in January 2014 and was tasked with investigating the dynamics in the private healthcare market.

Health minister Zweli Mkhize has thrown the medical schemes industry a lifeline, with provisions in the latest iteration of the National Health Insurance (NHI) Bill that enable them to continue until the ambitious scheme for universal health coverage is fully implemented

THE long-awaited National Health Insurance (NHI) Bill was introduced to Parliament this morning. The bill is important because it is the first piece of enabling legislation for the government’s ambitious plans for implementing universal health coverage, which it calls NHI.

Medical aid schemes have become a law unto themselves with untold power to determine which private doctor practices in the country should close shop.

Dr Aslam Vallee testified that even if innocence was proven, the persecution and harassment continued.

The Council for Medical Schemes initiated a probe which is hearing testimonies from black, Indian and coloured doctors who have accused medical aid schemes of fraud, intimidation and being forced to break patient-doctor confidentiality, among other things. 

The Section 59 investigation was probing allegations of racial profiling and withholding of payments to black and Indian doctors by medical aid schemes.

The Council for Medical Schemes (CMS) has called for clarity on how and when medical schemes can withhold payments to medical practitioners when suspecting fraud and abuse of funds.

Several doctors started testifying on Monday at the Council of Medical Schemes’ probe in Centurion, south of Pretoria, into alleged discrimination against Black and Indian doctors

The provincial health department is capable of spearheading the implementation of the National Health Insurance, says MEC

Team leaders, funding, planning and budgeting are how the health department can improve on its National Health Insurance (NHI) pilot projects.

The Council for Medical Schemes continues with plans for a registry

National health insurance (NHI) is one step closer to becoming a reality after Cabinet approved the NHI Bill of 2018, ready to be tabled and debated in Parliament, Minister in the Presidency Jackson Mthembu announced.

"In 2018, Cabinet approved that the Bill be released for public consultation over a three-month period, from June to September 2018.

An investigation into alleged unethical practises by medical aid schemes will begin on Monday. Black and Indian medical professionals have accused medical aids of harassment and exploitation.

The Council of Medical Schemes will begin its inquiry on Monday. The hearings are expected to run from July to September.

The Research and Monitoring Unit in conjunction with the Benefits Management Unit published a circular on the evaluation of contribution increase assumptions for 2019. The analysis shows that the weighted total consumption increase for 2019 was 8.63%...

One idea to consolidate the industry is to create ‘umbrella’ entities similar to umbrella retirement funds.

THE COUNTRY’S health-care-funding industry is approaching a crisis point: less than 16% of South Africans are on a medical scheme, health-care costs are consistently above inflation and consumers are battling to absorb the increases and maintain their cover. 

The Portfolio Committee on Health was briefed by the Department of Health on its annual performance plan and budget for the 2019/20 financial year.

The committee said South Africa is known as one of the most unequal countries in the world and the health sector contributes to this perception. The committee indicated that the Minister of Health, Dr Zweli Mkhize, has the silver bullet to change all that, by ensuring that rich and poor have equal access to healthcare.

PRETORIA, June 11, 2019 - The Council for Medical Schemes (CMS) said on Tuesday Advocate Tembeka Ngcukaitobi hasagreed to chair the investigation into allegations of racial profiling against Black, Coloured and Indian private medical practitioners. The investigation, to be called the Section 59 Investigation follows allegations by members of the National Health Care Professionals Association (NHCPA) that they were being unfairly treated and their claims withheld by medical aid schemes based on race and ethnicity.

The Council for Medical Schemes (CMS) has announced that Advocate Tembeka Ngcukaitobi will chair a four-month investigation into allegations of racial profiling against black and Indian private medical practitioners by medical aids, including allegations of the "use of hidden cameras"

Dr Zweli Mkhize will take over as the new Minister of Health, President Cyril Ramaphosa announced on Wednesday.

Mkhize is the former Minister of Cooperative Governance and Traditional Affairs and served as the Treasurer-General of the African National Congress between 2012 and 2017. He obtained a degree in medicine from the Univerity of Natal at the age of 26.

NEHAWU statement on the announcement of the Cabinet

The National Education, Health and Allied Workers’ Union [NEHAWU] welcomes the announcement of the incoming Minister and Deputy Ministers as announced by the President of the Republic, Honourable Cyril Matamela Ramaphosa.

The private healthcare industry and civil society will be looking to new health minister Zweli Mkhize to provide clarity on where the government is going with its long-awaited National Health Insurance (NHI) policy, which made little progress under his predecessor Aaron Motsoaledi

Shot-caller, calculated, master of survival. This is who South Africa’s new health minister, Zweli Mkhize is, analysts say.

The Council for Medical Schemes announced on Monday that it has launched an investigation into allegations of racial profiling against black and Indian private medical practitioners by medical aids.

Discovery Health has denied allegations of racial profiling levelled against the organisation on Monday.

A group of Black and Indian private medical practitioners on Monday alleged that they were being unfairly treated by medical aid schemes based on the colour of their skin and ethnicity.

UKheshe, the QR cash card, has announced the launch of uKheshe Life, a hospital, disability and life benefits card, offering all of the features that the normal uKheshe QR card does, but also including added hospital and life benefits for the card holder.

Netcare has warned that SA’s healthcare sector remains embattled due to a weak economy. The company reported on Monday a tepid 2.4% rise in interim underlying adjusted headline earnings per share.

CEO Richard Friedland joined Business Day TV to discuss the plans the group has put in place to cope with the challenging environment.

Bronchopneumonia is the most common clinical manifestation of pneumonia in the pediatric population, and the leading cause of death in children under the age of 5 years. Globally, pneumonia accounts for 16% of all deaths of children under the age of 5 years. A total of 920,136 children died in 2015 as a result of pneumonia. 

SOME employers are not waiting for the elusive National Health Insurance (NHI) scheme
to improve the health of their workers, absenteeism levels and productivity.

DIAGNOSTIC testing for six rare diseases can now be performed in the country thanks to American biotechnology company Sanofi Genzyme, in collaboration with the Centre for Human Metabolomics (CHM), which is affiliated to North-West University

HOSPITAL group Life Healthcare is mulling its options on where to invest some of the proceeds from the sale of its stake in Max Health. One potential area for investment is diagnostic imaging.

PRIVATE label products, growth in its wholesale business, smaller stores and new outlets are among the reasons Clicks turned in yet another strong performance, outpacing its rival Dis-Chem. 

THE medicines regulator is working closely with police to clamp down on illegal sales of unregistered cannabis-containing products with claimed medical benefits but has yet to successfully prosecute any company or individual breaking the law, according to a senior official at the SA Health Products Regulatory Authority (Sahpra)

Butsi Tladi, MD of Alexander Forbes Health, says the Conduct of Financial Institutions (COFI) Bill will promote financial inclusion and transformation.

The COFI Bill is the next phase of legislative reforms that set out to strengthen the regulation of how the financial services industry treats its customers.

The ruling party has announced its plan to forge forward with the National Health Insurance (NHI) under President Ramaphosa’s leadership

Pop symptoms of a headache into a search engine and it will come back with a myriad of diagnoses, varying from a sinus headache to a tumour. Dr Google has become the source of choice for self-diagnosis, a second opinion or to find out more about a diagnosed condition

The 2019 flu vaccine is now widely available across South Africa for a cost well under R100 – and that represents a significant saving over the cost of symptomatic relief, Business Insider South Africa's comparison suggests.

The Competition Commission’s health market inquiry (HMI) has extended the deadline for publishing its final report to September 30, the latest in a series of delays to the five-year probe.

Julia Brown, medical aid consultant: When people look at a medical aid they look at what they will pay and not always at what they will get for the money they pay

Knowing your healthcare cover well and being network-savvy can save you unexpected costs and admin time. So, take a little time to know your cover. You may be surprised to see how convenient it is to use networks and the extra value you get

MEDICAL schemes have a medical scheme rate, which is the maximum amount they will pay for a treatment. This rate differs depending on the medical cover you have, but it is typically a maximum of 200 percent of the scheme rate

SAVE ON HEALTHCARE

Healthcare in South Africa is extremely expensive. The cost of medical consultations, procedures and medications continue to rise annually. Without the assistance of a quality medical aid scheme, you would be left to fend for yourself when it comes to your health and the wellbeing of your family.

President Cyril Ramaphosa says all South Africans must be able to access quality healthcare regardless of their socioeconomic status or ability to pay.

JOHANNESBURG – The African National Congress (ANC) has reiterated its commitment to accelerate the implementation of the long-delayed National Health Insurance (NHI) bill through the finalisation of legislation and creation of a publicly funded National Health Insurance Fund.

Jeremy Yatt, principal officer of Fedhealth says the scheme is delighted with the approval, particularly considering this is a significant departure from how other medical schemes in South Africa manage their day-to-day benefits. Traditionally members have been charged for day-to-day benefits from the beginning of the year regardless of whether they have seen a doctor or purchased medicine or not.

This new bigger and better scheme will be known as Fedhealth, and since Topmed will be joining Fedhealth, it will not affect Fedhealth members in any way in terms of options and benefits.

Policy certainty is necessary for sustainable investment in a sector. Currently, there is considerable policy uncertainty in the health sector in SA, mainly due to three parallel policy processes - the Health Market inquiry (HMI) Provisional Findings and Recommendations Report, the National Health Insurance (NHI) Bill (the June 2018 version and the expected further version) and the Medical Schemes Amendment Bill (MSAB).

The Competition Commission’s long-running health market inquiry has delayed publishing its final report until March 29 2019, saying it needs more time to consider the extensive submissions it has received from stakeholders since it published its interim findings in July.

Jeremy Yatt, Fedhealth:  The Council for Medical Schemes has officially approved Fedhealth’s new option range for 2019, as well as the new MediVault and Wallet facility that will be applicable to its new flexiFED options.

National Health Insurance (NHI) projects will be put on the back-burner as the health department has to reprioritise its budget, Health Minister Aaron Motsoaledi said.

The minister was speaking to journalists on the sidelines of the University of Stellenbosch Business School event on Thursday.

THE Health Department says it is abandoning pap smears and will now offer a more sensitive test for cervical cancer.

Speaking during the launch of the national cancer campaign in Pietermaritzburg yesterday, Health Minister Aaron Motsoaledi said a sensitive test called liquid based cytology would now be made available in public healthcare centres.

Jeremy Yatt, Fedhealth:  The concept of medical savings accounts (MSA) emerged in the industry in the early 1990s, reputedly when Discovery founder Adrian Gore was working at Liberty. At that time medical scheme benefits for different kinds of day-to-day healthcare were specified, so for example, members would get a certain amount of Rands to spend on over-the-counter medicines, or for optometry services.

The results of the annual Sunday Times Top Brands survey were announced at an awards ceremony hosted at The Empire venue in Parktown, Johannesburg on Wednesday, 24 October, seeing two local companies excel as the overall winners in their sectors, and Ogilvy SA as top creative agency in support of winning brands....

Business categories:  Discovery Health Medical Scheme fought back from third place in 2017, to claim the Grand Prix award as the 2018 Business Overall Favourite Brand. Vodacom was nudged into second place, with the Apple iPhone in third... Brands that won in the other 12 business categories included: Kulula.com, Avis, Mercedes-Benz, Liberty, Santam, FNB, Apple iPhone, Vodacom, Allan Gray, Discovery Health Medical Scheme, Glenfiddich and Business Day... Medical Aid Companies 1 Discovery Health Medical Scheme 2 Momentum 3 Bonitas...

PRETORIA - Finance Minister Tito Mbweni said on Wednesday that government would be reprioritising R546 million within the National Health Insurance (NHI) indirect grant to address the critical shortage of medical professionals and to procure beds and linen for public healthcare facilities.

The NHI is government's primary healthcare policy aimed at changing the purchase and delivery of health services by addressing inequalities between the private and public sectors, which serve a population of about 16 percent and more than 85 percent, respectively.

It is with a great measure of delight and satisfaction that Genesis Medical Scheme is able to announce, for the 7th year running, the lowest average contribution increase of all open medical schemes for 2019.

According to Dennis van der Merwe, the Principal Officer of Genesis Medical Scheme, the average contribution increases announced by some of the bigger open medical schemes for next year is currently 10.3%. The good news for Genesis’ members, on the other hand, is that their increase will average only 5.5% in 2019 - almost half of what members of other medical schemes may have to fork out.

JOHANNESBURG - Up 20% of high school pupils in the country have tried to take their own lives, according to the Psychiatry Management Group (PsychMG).

Wednesday, 10 October will be World Mental Health Day, an annual event to raise awareness about issues around mental health around the world

The healthcare industry in SA is in constant flux, perhaps more so at present than in recent years, given an increasingly unstable economic landscape and the proposal of new NHI regulations.

Fedhealth: "They want a say over what their cover should be and how benefits are used, "writes Alf James
We believe it is going to transform the industry and change the way medical aid benefits are structured

The South African Society of Anaesthesiologists (Sasa) has introduced an alternative reimbursement model that is set to benefit patients and encourage best practice among clinicians in the private healthcare sector.

AS MEDICAL SCHEMES, members and employers brace for the 2019 financial year, they do so against the backdrop of a technical recession, a VAT increase, petrol price increases and marginal legislative space to innovate

It’s that time of year again, when medical aid schemes announce their benefit changes and costs for the year ahead. Given that medical aid costs are escalating faster than inflation, it can be tempting to look for ways to save. But it’s important to properly consider your circumstances and your health before ticking the box for the least expensive option.

Profmed, Graham Anderson - It’s hard to stay healthy in this modern day of fast foods, binge-watching and instant gratification. The good news is the life expectancy at birth for South African men has increased from 54 years in 2009 to an estimated 61.2 years, according to the latest figures from Statistics SA, announced in a media release by Profmed.

In a first for the medical scheme industry, Fedhealth has announced its 2019 benefit options which features a revolutionary new approach to benefits that gives consumers more flexibility, choice and control.

Insurer Discovery has opened up its weekly Vitality Active Rewards and Vitality Drive programmes until December, in what it’s calling the Vitality Open, to incentivise anyone to get active and drive well. This is part of a broader overhaul to Vitality Rewards 2.0.

With a wave of populism and an election around the corner, there is a risk that we will not navigate the tricky waters ahead with sufficient care and end up blundering into dead ends or running those still functioning parts of our healthcare system on to the rocks.

The Medicines Pricing Committee has submitted recommendations to Health Minister, Aaron Motsoaledi following requests from pharmaceutical companies for an additional increase of the single exit price (SEP) on medicine amidst a sliding rand and increasing input costs

Lack of flexibility regarding their unique healthcare needs is listed as the single biggest concern of medical scheme members. Jeremy Yatt, Principal Officer of Fedhealth Medical Scheme

The NHI System as outlined in the NHI Bill Our initial reflection on the proposed NHI system outlined in the Bill, is that it is pragmatic and workable. The Bill proposes the establishment of the NHI Fund and its associated governance and advisory structures.

Raising the hope of the private sector in contributing to a sustainable universal healthcare coverage system