FA News - 7 January 2020
Dr Sipho Kabane, CEO of the Council for Medical Schemes
"If the enrolment of membership to schemes has been stagnant and the proportion of the population that enjoys medical scheme cover has decreased during past decade, why is the regulator discontinuing the Low-Cost Benefit Option (LCBO) intended to increase the affordability of medical schemes.
Having seen a modest a modest growth of 6.7% from 8.32million to 8.8million between 2010 and 2017 and the proportion of the population that enjoys medical scheme cover over the same period having decreased from 16% to 15.9%, it has now become clear that we need change.
Has the Council for Medical Schemes gone rogue? No. The truth is health care delivered within a well organised, team-oriented, universal access national systems will improve outcomes, sustain national economies and provide greater synergy of health, wealth and social well-being than when fragmented aspects of health care are provided in a highly commercialised environment.
INCREASING AFFORDABILITY
The concept of a LCBO is intended to increase the affordability of medical schemes and membership through the development of a product targeted to a specific group of the population, mainly low-income households so that they would be able to afford medical scheme cover.
Generally, these households cannot afford high medical scheme premiums – the premiums paid determine the quality of benefits medical scheme members can receive. While higher premiums covered richer benefits, there was an opportunity to offer lower-income earners inferior benefits.
Mainly, such products potentially use the state as a designated service provider without entering into the necessary agreements with the State and lack prescribed minimum benefits."
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