Category Archives: Medical Aid

Information on Medical Aid schemes in South Africa

Medical Aid – Making the right choice

You Need Posted on by

Private and public healthcare has been in the news lately and will continue to be a topic of discussion due to the Department of Health’s proposed National Health Insurance (NHI) Bill, the Health Market Inquiry (HMI) report as well as the current socio-economic landscape.

Traditionally, this is the time of year when private medical aids present their products, plans and pricing for 2020 to existing members or potential members, so that they can make informed choices. “It is imperative that the decision you make regarding your and your family’s health and wellness is balanced against affordability,” explains Lee Callakoppen, Principal Officer of Bonitas Medical Fund.

“For existing medical aid members, it’s the time to analyse the plan you are on, whether it meets your health needs and compare it to the various options available.”

Medical aid plans can be confusing which is why it’s important to compare the various options and benefits to ensure you find a medical aid that works for you and your family’s health and that is within your budget. For people who have a broker, that should be the first point of call to help you can make an informed decision.

Here are some steps to help simplify the decision.

Analyse your healthcare needs

Completing a quick personal healthcare needs’ analysis will help you determine what level of cover you need. If you have dependants, factor in their healthcare needs too. Consider how much you and your family spent on medical expenses over the past year as a guide and then ask the following:

  • How often did your family visit a doctor?
  • Do you require medicine often?
  • Did you or the family need to visit a specialist?
  • Are any of you in need extra cover for cancer, HIV, renal failure or any other specific conditions?
  • How much did you spend on dentistry, optometry and over-the-counter medicine?

Then consider which expenses were once-off and won’t come up again soon (like childbirth) and which are likely to come up again and again (such as flu) as well as chronic conditions like high blood pressure and diabetes.

Check how much cover you require

If you find you hardly claimed (if you are on a medical aid) or have very few medical expenses, then you will need a lower level of cover. However, if you have a large number of medical expenses, you will require one of the more comprehensive plans. Once you’ve established this, you can decide whether you require a full medical aid or a hospital plan.

Are you happy to use a network

Some plans require you to use a specific GP, hospital network and have a list of Designated Service Providers (DSPs). This helps to keep costs down because the Scheme will have negotiated special rates with these services providers. Check whether there is a wide enough network in your area to cover your specific needs.

Check your budget

Once you have an idea of what you might need for the year ahead in terms of healthcare, then it’s time to look at your budget. Decide what you can afford and remember that the rule of thumb is that contributions should not exceed 10% of your monthly income.

Read the small print

Make sure you read all the details, including the benefits. These vary from plan to plan so establish what is covered and look at whether it offers additional risk benefits which can potentially save on day-to-date expenses. These could include anything from free wellness screenings (blood pressure, cholesterol, blood sugar and BMI measurements) through to maternity benefits, flu vaccinations, mammograms, pap smears and HIV tests. All of these are costly if you have to pay for them yourself.

What about savings?

Medical savings are a fixed amount a medical scheme gives you at the beginning of the year. You can use your savings for daily out-of-hospital medical expenses, such as GP and specialist consultations and over the counter medicine. There are ways to maximise your savings but first you need to know what you annual allocation is.

Age can influence the decision

If you have young children, ensure that the medical aid option you select provides sufficient child illness benefits. For young couples looking to start a family, ensure the option provides sufficient cover for maternity benefits. However, if you aging then you need an option that covers chronic conditions and provides sufficient in-hospital cover in the event of hospitalisation.

Some additional advice

  • Remember to be honest on your application form, disclose all information about you and your dependents’ health. Membership can be suspended or cancelled if you fail to do so.
  • Any waiting period or exclusions? Schemes may impose certain waiting periods for new members joining or for a pre-existing medical condition. This is based on the guidelines of the Medical Schemes Act and the specific scheme’s rules.

Finally, get expert advice

“Your health and that of your family is important so it is vital that you are comfortable with the choice you make and are confident your healthcare needs will be taken care of,” says Callakoppen. “My advice is to make sure you are informed. Read the information and fine print and compare what the different plans are offering before you commit. If you are still unsure, phone the scheme and ask questions or check with your broker or financial advisor.”

Medical schemes performance underwhelming

You Need Posted on by

As the economy bites and more consumers are downgrading their medical scheme cover to lower benefit options to cut costs, they are not realigning their ‘consumption-based’ expectations and are struggling to decipher the complexity of benefit options and scheme rules.

The South African Customer Satisfaction Index (SA-csi) for Medical Schemes (2019) provides insights into the overall level of satisfaction of customers of medical scheme providers – Bonitas, Discovery, Gems, Medihelp and Momentum. Gems is the only closed medical scheme included in the survey. Consulta, which conducted the survey, polled 1,707 medical scheme members across five of the leading schemes by membership numbers.

Overall, customers indicated that they do not believe that the premiums paid match the quality of cover and experience on offer. Across the board, the industry is struggling to meet the needs of customers in terms of benefit design that meets the needs of customers in a simple and transparent manner. No outright leader was identified in this year’s index, with Bonitas and Discovery obtaining a joint leadership position, Medihelp coming in on par with the industry average (72.9) while Momentum is just below par and Gems lagging in last place.

Customer satisfaction – overall index

Bonitas (75.1) and Discovery (74.8) lead the industry, Medihelp (73.5) come in on par with the industry average score of (72.9), while Momentum scores just below and Gems with the lowest score at 68.3. Overall customer satisfaction for the industry has increased to 72.9 compared with 71.6 in 2018.

Bonitas and Discovery were the only two schemes to show an improvement on 2018 scores, with Bonitas showing a big improvement of 4.9 index points in 2019, followed by Discovery with 1.7 index points.

Gems (-0.5), Medihelp (-1.6) and Momentum (-1.3) showed a decline on overall customer satisfaction compared with 2018 scores.

While Discovery, Gmes, Medihelp and Momentum have stayed relatively stagnant on overall customer satisfaction scores for the last two years, Bonitas has made a significant improvement in 2019, suggesting that recent strategic reviews of its benefit options and member focus are starting to pay dividends.

Customer expectations and perceived quality

Across all brands, customer expectations are not being met consistently. South African customers have very high expectations of their medical scheme providers (industry average of 80.6) given the fact that it’s an expensive buy and communication around benefits is often not done clearly.

Bonitas and Medihelp are the only two brands that showed a positive gap – albeit marginal – where perceived quality meets customer expectations.

Perceived value

Perceived value is a measure of the quality, relative to the price paid. The perception of value for money is a very strong predictor of future usage and company growth.

In terms of the value index, Medihelp (71.6) takes the lead, Bonitas (70.9), Discovery (70.6) and Momentum (71.4) are all on par with the industry (69.6). Gems is below par at 66.1. Bonitas and Discovery are the only two schemes that saw a marginal increase in perceived value score compared with 2018.

However, when perceived value is overlaid with the price-quality alignment, customers of all brands feel that the premiums charged do not match the quality of the cover and experience on offer. In this regard, Discovery has the biggest gap (-6.2) in perceived value and price-quality alignment, followed by Bonitas (-5.8), Medihelp (-4.9), Momentum (-3.9) and Gems (-2.3).

Complaints incidence and resolution

Of the complaint incidence across the industry, customers complained most about fees and charges (22%), claims issues (19%), terms of cover or scheme rules (13%), feedback (9%) and waiting time (7%).

Discovery and Medihelp have the most complaints about fees and charges, both at 28% and above industry average (22%).

Medihelp has the highest incidence of claims-related complaints at 26% and well above industry par of 19%.

In terms of complaints incidence and handling the industry average of complaints incidence is 15.9/100 and complaint handling is 48.6/100.

Discovery has the lowest complaint incidence at 13.2/100 and complaint handling of 51/100. Bonitas’ complaint incidence is at 14.3/100 and complaint handling of 51.5/100. While Medihelp has a complaint incidence slightly higher than industry par at 15.8/100, its complaint handling score is well above industry par at 55.7.

Momentum and GEMS perform below average in this category.

Customer loyalty

Bonitas has the most loyal customers at 69.4%, above industry par of 64.0%, and has also seen a big improvement of 7.5% in loyalty score compared with 2018 (61.9%).

Discovery, Medihelp and Momentum all saw a decline in customer loyalty scores.

Net promoter score

This measures the likelihood of a person recommending a brand.

Bonitas has the highest net promoter score (NPS) at 21.6%, which is well above the industry average (9.5%). Customers are active promoters of the brand to others, with 45% of customers recommending the brand. It also has the lowest number of detractors at 24%.

Compared with 2018, Bonitas has seen a radical increase in NPS score when it came in at a low of 2.6%, suggesting that its focus on benefit simplification and customer satisfaction and complaints handling have had a marked impact on how customers perceive the brand, and their willingness to endorse it to others.

Discovery follows with an NPS of 14.5% which is on industry par and marginally up on its 2018 score of 12.2%. 41% of Discovery customers actively promote the brand, and 27% are detractors.

The balance of scores see a big drop-off on NPS performance well below industry par – Medihelp (10.9%), Momentum (8.4%) and Gems (-6.7%).
Gems has a high percentage of detractors at 43%, well above its promoters at 36%.

Treating Customers Fairly (TCF)

The degree to which customers feel they are being treated fairly by their medical scheme is highest with Medihelp (78.2) and Bonitas (78.9) – both above the industry score of 76.2.

Discovery follows with a score of 77.1 which is in line with the industry.

Gems (73.6) and Momentum (72.9) are lower than the rest of the industry.

Overall score

The make-up of the overall TCF score looks at seven key aspects including:

  • Fair treatment of customers
  • products and services that address customer needs
  • Transparent and easy to understand information
  • Advice that is suitable for the customer’s circumstances
  • Products and services deliver as expected
  • It is easy for customers to claim, change provides, complain or consider other providers
  • Customers are treated with respect and there is an open relationship

Annual private healthcare increases have been well above, if not double inflation, for more than two decades now which has steadily eroded the benefits that consumers can afford, with many forking out as much as 20% of their monthly income for medical aid. In response, consumers have opted to downgrade to more affordable benefit options.

HMI recommendations will contribute to universal coverage

You Need Posted on by

Once implemented, the majority of recommendations in the Competition Commission’s Health Market Inquiry (HMI) will provide a conducive environment for attaining universal health coverage.

“These recommendations introduce mechanisms for progressive and positive changes to occur in the private healthcare market, such as moving towards alternative reimbursement systems and away from the traditional fee for service system, which has led to perverse incentives,” Lerato Mosiah, CEO of Health Funders Association (HFA), says.

The recommendation for maximum tariffs for Prescribed Minimum Benefits (PMBs) is positive. However, Mosiah believes that in order to achieve this, funders and providers should come together to work on an industry wide single set of billing codes before the Supply Side Regulator for Healthcare is established, as suggested by the HMI. Clarifying the definitions of PMBs will also assist with this.

The HFA agrees with the recommendation for an industry-level role for health technology assessment and believes that this will assist the entire industry to make funding decisions based on the quality and efficacy of new technology entering the market, such as biological medicines and new equipment. This competency will also improve the health system’s capacity to assist patients with rare diseases.

“Most other health systems in the world rely on a central entity for health technology assessment in order to provide guidance in benefit design and funding decisions. In South Africa, each medical scheme has been left to do this work on their own for their own members. This is not only a duplication of work but also a waste of funds”, she said.

The association welcomes the proposed mechanisms to introduce greater transparency for members of medical schemes, such as a standardised benefit option and comparable top-up cover, as these will empower members to make more informed decisions about their healthcare.

The HMI also emphasises the importance of a well-functioning medical schemes market in healthcare provision. The recommendation for the creation of a risk adjustment mechanism may contribute in this regard and would close some of the gaps in the incomplete private healthcare sector regulatory regime.

“The recommendations will bring about more cohesive and efficient private and public healthcare sectors that will improve the quality of care experienced by patients,” concludes Mosiah.

NHI written submissions deadline extended

You Need Posted on by

The deadline for written submissions on the National Health Insurance (NHI) Bill has been extended to end of November.

The original closing date for written submissions was 11 October, but given the magnitude of the NHI, the Portfolio Committee on Health received numerous requests from stakeholders for an extension to mid-November.

“We have been considering the requests from relevant stakeholders who play an important role in the delivery of healthcare in the country. We have actually agreed to extend the closing date for written submissions to 29 November 2019,” Dr Sibongiseni Dhlomo, chairperson of the committee, said.

The new closing date for the written submissions doesn’t affect the start of the public hearings, which are scheduled to start on 25 October 2019 in Mpumalanga.

Written submissions must be directed to Vuyokazi Majalamba and be addressed to the Portfolio Committee on Health 3rd floor, 90 Plein Street, Cape Town 8000 or e-mailed to vmajalamba@parliament.gov.za, or faxed to 086 6943279 by no later than 29 November 2019.

In addition to the written comments, people should indicate their interest in making a verbal presentation.

Know your business inside out with a Biz Office

You Need Posted on by

New expectations of transparency and authenticity in business means things like organisational purpose, brand stories, how your company does things, what it believes in and what it stands for, can all play a part in how your company sees itself and how it is seen by others.

Being open, authentic and transparent about the organisation is the new norm

From global giant to startup, every company website has an About Us page. Revisiting this vital ‘About Us’ content can be a starting point in ensuring core company information and values remain relevant or the reevaluation of how they may have shifted due to changing market conditions since they were first written.

Why is vision important?

According to Forbes, “Employees who find their company’s vision to be meaningful have average engagement scores of 68%, while the average for those who don’t is down around 18% – a sizeable difference! Interact-intranet.com

Cleverism.com states: “By creating a vision statement, you are boosting the long-term success of the organization through better strategic planning. You define the values and the guiding objectives for the business, making it easier to plan future actions. But you are also improving the bottom line because you align the business’ processes with the vision and you inspire your employees and stakeholders to subscribe to your vision… get to the heart of what it is your business does”.

How a Biz Press Office can clarify vision inside and out

The “glass box” nature of a Biz Press Office offers a shop window, which effectively communicates corporate vision both internally and outwards to external prospects and stakeholders. These vision statements can be core to your company’s content strategy.

“About 70% of workers don’t understand company’s vision at all. Not only is this bad for engagement but if an employee doesn’t understand the company vision, they likely don’t understand specific goals either. This makes it nigh on impossible to align their work with overall strategy.” Interact-intranet.com

Bizcommunity’s multi-industry B2B environment provides front-page distribution for branded content ensuring the window on your organisation’s reputation stays polished and relevant, allowing it to embrace the new trends in business transparency and authenticity. Seven-day website front page, newsletter and mobile exposure across 19 industries in Africa is just the start of the journey for company news on Biz.

With a vision statement, you are saying, “this is where we want to be, this is what you deserve to create”. Cleverism.com

Your company thought leadership, opinion, white papers, branded content and event news distributed to our 464,000 readers, offer a vital window into the intellectual capital of our region for local, global and pan-African audiences.

Polish your company vision.

Join over 400 top companies publishing in 19 industry sectors on Bizcommunity: moc.ytinummoczib@selas

FIND OUT MORE

HMI report: Private sector characterised by high costs and no competition

You Need Posted on by

The Competition Commission’s long-awaited Health Market Inquiry (HMI) has found that the private healthcare sector is “highly concentrated”, “characterised by high and rising costs of healthcare and medical scheme cover, and significant over-utilisation without stakeholders being able to demonstrate associated improvements in health outcomes”.

The panel found there are three hospital groups dominating the market – Netcare, Mediclinic and Life Healthcare, which has potential to “distort and prevent” competition. More competition, it said, would translate to lower cost and prices and more “value for money” for consumers.

However, Mediclinic has challenged this assertion, saying it (and the other two groups) had submitted data analyses and research studies indicating that the conclusions are “incorrect and outdated”.

“It is important to note that the market context has moved on since 2014; the end date for the majority of data used. Current data must be used to find current best solutions for the unique South African healthcare market, especially as South Africa prepares itself for the introduction of the NHI,” said Koert Pretorius, CEO of Mediclinic Southern Africa.

The report recommends that a number of oversight bodies be set up to rectify regulatory failings related to private healthcare.

Supply Side Regulator for Healthcare (SSRH)

The National Health Act of 2003 makes provision for appropriate geographical distribution of facilities based on population need. However, when the National Department of Health’s tried to implement this measure, 11 years later, it failed because it didn’t have the necessary regulatory framework necessary for implementation.

The report therefore recommends that the SSRH be set up to regulate health facilities and practitioners. Its duties will include capacity building and issuing facility licences that follow national guidelines developed by a technical team.

It will also set up a negotiating forum for practitioners to set a maximum price for prescribed minimum benefits or PMBs. Additionally, practitioners will also set reference prices for non-PMBs.

Outcomes Monitoring and Reporting Organisation (OMRO)

This body will be set up as a platform for providers, patients and all other healthcare stakeholders to provide “patient-centred” and “scientifically robust” information on healthcare outcomes.

As hospitals, doctors and patients cooperate in generating information on healthcare outcomes, it will provide practitioners and hospitals with relevant information and ways to improve clinical quality.

It will also help provide patients and funders with relevant information on health outcomes for decision-making purposes.

Health Professions Council of South Africa (HPCSA)

Changes in the ethical rules of the HPCSA would promote innovation in models of care, the report said.

This includes mandatory ethical training at both undergraduate and postgraduate level so future healthcare professionals are aware of cost implications of their decisions.

“The existing HPCSA ethical rules prohibit joint initiatives to develop new efficient and cost-effective care delivery models,” Mediclinic said.

Medical schemes

“The principal officers and trustees of schemes could be more active in ensuring that beneficiary interests are protected… there is a need to strengthen the role played by the boards of trustees and principal officers to ensure the member is always put first,” the report read.

In addition, it proposes a single, comprehensive standardised base benefit option will be introduced and offered by all schemes.

This is “to increase comparability between schemes and to increase competition in the funders market,” the report read. This will enable consumers to compare products, reward funders able to innovate and offer lower prices or at a higher quality.

Mediclinic supports bilateral tariff negotiations between facilities and funders. “Quality outcomes information has been an ongoing issue as flagged by Mediclinic’s participative submissions in the HMI process… This will provide patients, healthcare professionals and funders with greater transparency on clinical performance information,” the group said.

Top ratings for Biz Rate Card 2019

You Need Posted on by

Bizcommunity is excited to announce the relaunch of our Biz Product and Rate Card, featuring all-new product infographics and descriptors, as well as a product portfolio that is easier than ever to access and engage with! Contact us to position your company or organisation at the centre of your industry now!

Meeting the needs of companies to manage their online reputation, get ‘bums-in-seats’, fill job vacancies or other marketing objectives, Bizcommunity has been the heart and hub of South Africa’s promotions and PR industries for over 18 years.

Recommended promotional products:

  • Biz Press Office and Biz Platinum Press Office: The ultimate promotional offering, used by hundreds of PR companies, advertising agencies, financial services providers and more across 19 sectors, now offering even more great exposure options.
  • Top of the top-rated recommendations is Biz Promoted Content, offering your company news top-story and front-page status, among daily company and breaking news by industry.
  • The Biz Listing sees a new, clean design, offering the most cost-effective exposure, with full-width header images, logo, company description, listing of up to 10 services, social media links and map, may be showcased within three industry sectors for only R350/month or R3500/year. This product is great for SEO, brand exposure and to drive website traffic. We can also assist with set up. Click here to view an example.
  • Throwing an event? Event Offices and Event Sponsorships offer truly amazing response rates and exposure for invitations to industry awards, trade events, conferences, seminars and galas.
  • Jobs for Africa – Posting thousands of vacancies on behalf of our recruiting partners every month, the Biz Recruiter Office specialises in packages with many benefits for recruiting companies and HR specialists.
  • Sponsorship – Give your content the best possible exposure by choosing to own any of 19 portals, industry newsletters or mobile space.
  • Newsletter advertising – Your advertising messages in the inboxes of up to 370,000 subscribers daily or weekly via 21 industry-specific newsletters.
  • Website display advertising – Hit your B2B targets in any of 19 industry sectors or sub-categories with the option to pinpoint regions, cities or visitors from Africa.

Don’t let your company be out in the cold, join your Biz community, by contributing, subscribing, advertising or publishing. We invite you to take a look around our new Rate Card and chat to our online digital specialists about the right products for your company.

View the rate card

Membership growth and a weighted increase below double digits for Bonitas

You Need Posted on by

A growth in membership, an increased emphasis on Managed Care, a range of enhancements for members and added value, are just some of the highlights from the Bonitas 2020 Product Launch.

Lee Callakoppen, Principal Officer of Bonitas Medical Fund, announced that the increases for 2020 range from just 6.2% with an average increase on risk contributions of 9.4% and a weighted increase of 9.9%. ‘Taking into account the impact of the current socio-economic landscape on consumers, our focus is to add value while balancing costs.’

“Last year, we realigned our product offering based around member needs,” explained Callakoppen. “Through a product gap analysis we identified where our offering could be improved and addressed this. Bonitas attracted around 40 000 principal members during the first eight months of 2019, mainly due to the introduction of two new plans. PrimarySelect was the biggest growth area attracting 6 000 new members in the first month – but 42% of the business growth this year was drawn from the Primary, Primary Select, BonSave and BonFit plans.”

2018 reflections

In July, the Fund reported its financial results for 2018, announcing bolstered reserves from R4.0 billion in 2017 to R4.13 billion, despite difficult economic conditions. “This is satisfying, especially given the stagnant economy and other negative fiscal influences. Our strategic initiatives resulted in a positive impact with the Fund attaining a 25.2% solvency rate and achieving a surplus of R164.8 million.”

The year ahead

For 2020, the Fund has introduced new benefits, changed the name of BonFit to BonFit Select and kept increases as low as possible. “South Africans are under immense financial pressure. This combined with the concerns around the NHI Bill definitely impacts members,” says Callakoppen. “We’d like to assure everyone it is business as usual at Bonitas and quality, affordable healthcare for our members, remain a priority.”

Delivering healthy returns

Over the years, emphasis has been on our Managed Care initiatives, helping members to take control of their health to enjoy a better quality lifestyle. The successes:

  • Chronic medication: Around 187,000 members are enrolled on the chronic medicine programme, 79% of these are adhering to their chronic medicine regimens.
  • Diabetes: 60,000 are registered as chronic diabetic beneficiaries with 77.6% adherent to chronic medicine.
  • Mental health: There are around 28,000 unique registered beneficiaries with mental illness. 1,700 members have enrolled on the mental health programme and adherence to chronic medicine is 91.4%.
  • The DBC back and neck programme: Continues to enjoy a 91% success rate, with 3,200 members completing the programme with improved movement and functional rehabilitation. Of the members who completed the programme, only 5% required surgery.

Enhanced Wellness Extender

One of the Fund’s key initiatives for 2020 is an enhanced Wellness Extender benefit to include, amongst others, blood tests and x-rays available on all options, except BonCap without impacting on day-to-day benefits or savings. The Wellness Extender can be used across a range of services from GP consultations to physiotherapy and blood tests. The good news is this will be paid from the Wellness Extender first so members can stretch their benefits further.

Because completing a wellness screening is a prerequisite to accessing the extender benefit, we are rolling out screenings to Dischem and Clicks clinics and the greater public, through family days and activations. This will also allow the Fund to identify high-risk beneficiaries early and put them on the path to wellness.

More value for members

“In looking at our members’ needs, it became clear that they require additional out-of-hospital benefits for daily medical and day-to-day expenses such as acute medicine, blood tests and x-rays,” Callakoppen said. On some plans day-to-day benefits have been increased while on others the savings portion has been increased – the benefit increases range from 16-20%. On other options, the dental benefit has been restructured and in some GP visits have been increased.

Talking babies

Bonitas covers the birth costs of around 9,000 babies every year, 20% of these involve some kind of complication. For this reason the Fund firmly believes they need to offer pregnant women additional support and education. Next year the maternity benefit will allow one of the post-natal consultations to be used for a consultation with a lactation specialist. Moms will also be able to access vouchers for up to 70% off baby products and further discounts a Baby City from the voucher platform.

Bonitas is also in the process of establishing a comprehensive baby programme which will offer pregnant moms a range of benefits and care.

We hear you

The hearing aid cycle has been adjusted in line with international protocols, which show that the average lifespan of a hearing aid is approximately eight years. Hearing aids will now be available on five-year cycle from the date of last claim on BonComprehensive, BonClassic, BonComplete, Standard and Standard Select.

Run/Walk for Life and Eat for Life

The top four conditions suffered by our high-risk members are hypertension, diabetes, high cholesterol and heart disease. These conditions can be significantly improved by exercising regularly and eating a healthier diet. To this end, we have partnered with Run/Walk for Life which is offering Bonitas members a 70% discount. Members can join Run/Walk for Life and Eat for Life for R135 a month. As an added bonus, if a pregnant Bonitas mom joins the programme, her partner can join too at no cost.

Corporate wellness

There has been a distinct shift towards making employee wellness a serious focus to address work-life balance and maintain employee health. Our approach is to manage the health of the employees proactively by providing access to range of services from Health Risk Assessment, TB screening, optometry, prostate and breast screening, all delivered on site to avoid disrupting the work environment.

Improved value-adds:

We know South Africans are looking for added value and ways to save money every month. Attracting a younger, target market is vital to sustainability and they demand additional benefits over and above healthcare. This is why we introduced our value-added product model for 2019.

For the year ahead these include:

Improved access to free discount vouchers, with over 300 retail discounts available to members every month on groceries, travel, fashion and more. Discount partners include: Takealot, Planet Fitness, Checkers, PnP, Spar, Edgars, Dis-Chem, Baby City, Unilever and Tiger Brands.

MedGap has increased its limit to R165,000, introduced a trauma benefit for children under 5 and a R2,000 payout on confirmation of pregnancy, while offering Bonitas members a 26% discount. A special millennial gap product has also been released.

Sanlam Indie offers members a wide range of life, funeral, disability cover products and an exclusive benefit in the form of free investments up to 100% of monthly contributions, with Bonitas members receiving an additional 10%. In 2020, new Bonitas members will get R150,000 free life cover for three months.

And finally, MiWay is offering a 5% discount on household and motor insurance, a free tracking device and emergency transport benefit to Bonitas members.

“There are a number of issues facing South Africans,” says Callakoppen. “From healthcare inflation and the general high cost of living, to concerns regarding an increased prevalence of lifestyle diseases and mental health issues. However we have solid plans in place to help reduce the burden on our members with a renewed focus on prevention.

“We have a huge responsibility to find more affordable ways of providing quality healthcare We are pleased that our strategy is providing us with solid financial stability, to continue our innovation in terms of our offering going forward,” concluded Callakoppen.

Summary of key changes for the year:

  • Average on risk contributions is 9.4% with an average increase of 9.9%.
  • The name of BonFit has been changed to BonFit Select to highlight the rich network of providers. The option has also had an increase in medical aid savings to 16%. Members can also access two GP consultations when savings are depleted.
  • Savings on BonSave have increased to 20%.
  • Hearing aid cycle restructured to five years.
  • Dental benefit, paid for from risk, on BonSave and BonFit has been restructured to cover consultations and oral hygiene.
  • A 15% increase in day-to-day benefits on Primary and Primary Select. In addition, auxiliary benefits for PMBs will be unlimited in-hospital.
  • Enhanced specialised radiology benefits on BonEssential and BonEssential Select for in and out-of-hospital use.
  • Extended and broadened income bands for BonCap.
  • Enhanced maternity programme.
  • Improved Wellness Extender.
  • A 70% discount for members who join Run/Walk for Life and Eat for Life.
  • An enhanced multi-insurer platform with exclusive deals and offers for Bonitas members including gap cover and short-term insurance.
  • The establishment of the Bonitas Pharmacy network to enhance value for money.

For more information on the range of medical plans available from Bonitas, or to compare options, go to www.bonitas.co.za.

Have your say on the NHI bill

You Need Posted on by

The Portfolio Committee on Health has called on interested individuals and relevant stakeholders to submit written comments as well as indicate interest in making an oral submission on the National Health Insurance Bill [B11 – 2019].

“The objective of the Bill is to achieve universal access to quality health care services in South Africa in accordance with section 27 of the Constitution, to establish a National Health Insurance Fund and to set out its powers, functions and governance structures, and to provide a framework for the strategic purchasing of health care services by the Fund on behalf of users,” the committee said in a statement.

The Bill further aims to create mechanisms for equitable, effective and efficient utilisation of the resources of the Fund to meet the health needs of the population, to preclude or limit undesirable, unethical and unlawful practices in relation to the Fund and its users and to provide for matters connected herewith.

Written submissions must be directed to Vuyokazi Majalamba and be addressed to the Portfolio Committee on Health 3rd floor, 90 Plein Street, Cape Town 8000, e-mailed to

az.vog.tnemailrap@abmalajamv

or faxed to 086 6943279 by no later than 11 October 2019.

In addition to the written comments, individuals must indicate their interest in making a verbal presentation.

Copies of the Bill can be obtained from Vuyokazi Majalamba (021) 403 3770, cell 083 709 8522 or at www.parliament.gov.za.

South African taxpayers will bear the brunt of National Health Insurance

You Need Posted on by

But the Bill has sparked a great deal of controversy. The impact on private healthcare, quality of service and the government’s ability to manage such a complex system have been widely questioned.

One of the toughest questions being asked is: how on earth will it be funded?

The memorandum on the objects of the Bill explains that the NHI will be financed in various interrelated phases as determined in consultation with the National Treasury. Costing estimates vary from the health department’s “guesstimated” R259 billion last year, to the Institute of Race Relations calculation of R450 billion.

Read more:Why South Africa’s plans for universal healthcare are pie in the sky

National Treasury is currently doing the costing exercise. It has said it will release more information at a later stage.

What’s known about the funding proposals can be gleaned from the Bill itself. These four proposals target the same low-hanging fruit, namely income tax.

The four sources

Source 1: Existing tax revenue: This pool of general tax revenue includes funds currently directed to the provincial health departments (the so-called “provincial equitable share” and “conditional grants”).

The main public health funding stream consists of around R150 billion per year, which would be tapped for the NHI. The memorandum notes that this shifting of funds would occur in one of the later phases, and would require amendments to the National Health Act of 2003. It would also be dependent on how functions are shifted from provincial to national level; for example, if central hospitals were brought to the national level.

Source 2: Scrapping medical scheme tax credits: This entails the reallocation of funding for medical scheme tax credits paid to various medical schemes towards the funding of the NHI. In other words, the current tax relief provided for by the medical tax credits would fall away. The impact on, for example, a family of four, would amount to just over R12 000 per year. This means that the tax owing to SARS would increase by about R12 000 per year for the main member of the medical scheme.

Calculation of medical scheme tax credit = (R620 + R209 + R209) x 12 months = R12 456.

Source 3: Payroll tax on employeer and employee: The memorandum envisages that the payroll tax will be “small”. The Bill does not, however, quantify its “smallness” – or indeed, the magnitude.

In my view this payroll tax is in essence a tax on labour and productivity. For example, the payroll tax would inevitably result in reduced earnings or, worse, job losses.

Source 4: Surcharge on personal income tax: The Bill does not contain any information regarding this surcharge, other than that it would be charged on an individual’s taxable income. This extra tax on taxable income could be viewed as a penalty (or disincentive) for increased productivity and wealth – yet another reason why some might participate in the silent tax revolt.

Despite not knowing the percentage of additional tax that might be levied, it is important to look at the number of taxpayers who will have to bear this additional tax. This metric is called the tax base.

The tax base

The country has a narrow tax base, defined as the number of individuals who were assessed for personal income tax. This is not to be confused with the number of registered individual taxpayers, which has increased by 4.9% from 2016/17 to 2017/18. The increase may be ascribed to the revised employee registration process which was introduced by the South African Revenue Service in 2010.

This process requires employers to register all individuals and issue them with a tax certificate, regardless of the amount of income earned. However, many of these taxpayers fall below the tax threshold and are thus not assessed. They are also not liable for the tax employers deduct from salaries and wages and hand over to the South African Revenue Service.

Conversely, the number of taxpayers actually assessed (or taxed) showed a sharp decline. In the 2013/14 tax year, a total of 5,991,934 individuals were assessed. This figure dropped to 4,898,565 individuals assessed in 2016/2017. The tax base therefore shrunk by about 18.2% from 2014 to 2017.

In contrast, the personal income tax burden shouldered by these individual taxpayers has increased. This can be expressed as the average personal income tax paid per assessed taxpayer. In the 2013/14 tax year, the tax burden amounted to R45,702. This burden expanded to R65,601 in 2016/2017, representing a whopping 43.5% increase from 2014 to 2017.

The overall result is that relatively fewer taxpayers have to carry an increasing burden of tax collections. Given the country’s poor economic outlook, credit rating downgrades, high unemployment figures and the myriad of social grants paid to millions of dependent individuals, it is clear that the tax base is already severely strained.

The NHI will simply add to this burden.

Social solidarity

The Bill attempts to make the extra tax burden more palatable by saying that the money will be collected “in accordance with social solidarity”. This is an interesting phrase used by the drafters of the Bill. “Social solidarity” is a concept that was developed by the Frenchman Émile Durkheim in the late 1800s. Its core principle is that of collective action and enabling individuals to feel that they can enhance the lives of others.

The social solidarity envisaged by the memorandum is that of income cross-subsidies between “the affluent and the impoverished”. All well and good, until one considers that the payment of taxes is not a voluntary action done for the wellbeing of others. It is a legal obligation imposed by the State on its citizens. Social solidarity, therefore, implies a sense of altruism. A duty to pay income tax can hardly be said to be an act of selflessness.

Of course, what probably offends most taxpayers is not the communist undertone of social solidarity, which harks back to “from each according to his ability, to each according to his needs”. Rather, it is the sense of frustration with a government rife with corruption, the widespread misuse of public funds and the brazen lack of accountability. The NHI funding proposals may very well be perceived as adding insult to injury for the 4.9 million individuals paying personal income tax.

It is somewhat of a relief that (according to the memorandum) tax options will only be evaluated as part of the last stage of implementation. Hopefully, the National Treasury will do a full impact analysis and take into account the economic and fiscal environment prevailing at the time.

This article is republished from The Conversation under a Creative Commons license. Read the original article.The Conversation