Medical aid cover becoming unaffordable for the 'missing middle'

Clarence Ford is joined by Craig Comrie, chairperson of the Health Funders Association (HFA).

If you're a member of a medical aid scheme in South Africa, you'll know only too well that the perceived peace of mind for having cover, comes at quite the cost.

And annually, that cost keeps going up. Just in the past year, most medical schemes increased their premiums by 7 to 12%.

According to the HFA, even many South Africans considered to be comparatively well off, can no longer afford medical aid.

Comrie says the 'missing middle' needs to be accommodated through urgent revision of the regulatory framework, to provide affordable healthcare for medical aid members, and greater access to those without cover. 

"The legal framework for medical schemes is to provide a minimum set of benefits, which at the moment costs close to R1 300 per individual, per month."

Craig Comrie, chairperson of the Health Funders Association

"Under the Medical Schemes Act, the council has exempted those health insurers to provide benefits which are less cover than those which are provided in the medical schemes."

Craig Comrie, chairperson of the Health Funders Association

It's something that, from a regulatory space, leaves gaps which must be filled if the cost of healthcare for employed people is to be tackled, says Comrie.

"We need to reform our healthcare system to cater for everyone, and do better for everyone."

Craig Comrie, chairperson of the Health Funders Association

Comrie says the impact of the current situation means many are choosing to 'roll the dice' on their own health, and take the financial hit directly should they need medical care.

"We've seen a growing number of individuals actually start funding their own risk out of their own pockets."

Craig Comrie, chairperson of the Health Funders Association

Comrie says recent research shows that the number one reason for bankruptcy among middle- to higher-income brackets is healthcare.