Minister of Health, Dr Aaron Motsoaledi, on Thursday announced that co-payments on medical aids would be abolished. Speaking at a briefing on the Medical Schemes Amendment on Thursday, Motsoaledi said the Medical Schemes Bill was being amended to align with the National Health Insurance (NHI) white paper to achieve universal healthcare.
The proposed changes of the Bill was also gazetted on Thursday. The NHI is a health financing system that operates on pooled funds to provide access to all South Africans, irrespective of their socio-economic status.
As the NHI is being phased in, many beneficiaries now need relief from ‘serious challenges’ as a result of the current medical scheme regime. “The nature and magnitude of the challenges is that it will be undesirable for medical scheme beneficiaries to have to wait for long term changes,” Motsoaledi said.
He explained that only 10% of the country’s residents are able to afford private healthcare, and the importance of easing this financial burden on the average South African.
Co-payments being abolished effectively means that the medical scheme holder will no longer have to fork out bill payments – the full amount charged will be settled in full by the medical aid.
The National Department of Health’s data shows that medical aid schemes hold close to R60-billion in reserves. There is a statutory requirement that 25% of income be held in reserve in case of an emergency, but the Department has found that R60-billion is close to 33% of reserves.
“These huge reserves were accumulated partly through high premiums, but also by introducing the co-payments that medical schemes avoid having to pay or even dip into the reserves if the situation demands,” Motsoaledi said.
The amendments also propose that the use of brokers be abolished. “Almost two thirds of principal members of medical aid schemes pay monthly to a broker as part of their premium. Many of these members do not even know that they are paying this money which in 2018 is R90 per month,” the minister said.
Other amendments include the introduction of a cross-subsidisation model.
“The rich must subsidise the poor, the young must subsidise the old and the healthy must subsidise the sick,” Motsoaledi said.
The NHI Bill also seeks to establish a NHI Fund, which will act as a single public purchaser and financier of health services throughout South Africa.
The National Budget Treasury has allocated R4,1-billion-to NHI for the medium term.