By Rob Starr, Content Manager, Big4.com

According to the results of a survey conducted by Professional Services Firm PwC, South Africa’s medical schemes believe that the provision of healthcare in the country is deteriorating and that the introduction of the National Health Insurance (NHI) system will not necessarily resolve the current state of health services.

The survey focuses on strategic and emerging issues in the South African medical scheme industry. The main aim of the survey is to raise awareness of medical schemes to emerging trends and issues in the industry, identify industry trends, understand the strategic thinking of principal officers in the sector, and provide insight into how the industry may evolve over the next three years.

Medical schemes believe that NHI alone is not the solution to South Africa’s healthcare problems as working conditions first need to be improved and a total overhaul of basic resources should take place before the new system is implemented. A significant percentage of medical schemes (71%) had contribution rate increases of between 5% and 10% for 2012, with hospital and specialist expenses driving these increases.
The majority of medical schemes believe that wellness programmes, disease and lifestyle management initiatives will reduce costs for schemes.

In March 2012 National Treasury issued draft regulations on the demarcation between health insurance policies and medical schemes. A significant percentage of participants (70%) expect the intensity of regulation of medical schemes to increase substantially over the next three years. This is likely as a result of the pending Medical Schemes Amendment Bill as well as the increasing scrutiny of schemes by the Council for Medical Schemes. French says this is also not unexpected given the recent developments in respect of the payment of Prescribed Minimum Benefits.