Medical aid members have negative perceptions – survey

2011-03-28 13:15

A healthcare survey released today painted a picture of a struggling medical aid industry and unappreciative members.

“Rising healthcare costs are the biggest concern for employers, brokers and medical schemes within the healthcare industry. Medical schemes are still struggling to contain these costs. At the same time members perceive these benefits to be decreasing,” said Margaret Hulme, the head of healthcare consulting at Old Mutual Actuaries and Consultants.

Findings of the 2010 Old Mutual Actuaries and Consultants Healthcare Survey showed that many members did not understand the rules and structures of their own medical aids.

The survey was based on one-hour, face-to-face interviews with 83 employers, 15 brokerages and 21 schemes.

Employers and brokers saw the overall cost of Prescribed Minimum Benefits (PMB) as one of the main cost drivers.

Hulme said most schemes had been forced to reduce benefits where possible to retain their affordability.

“However, members do not perceive the PMBs as valuable enough to offset the reduction in other benefits.”

PMBs are a set of 270 medical conditions and 26 ongoing, serious chronic diseases that medical schemes must cover under every option of their offering.
But members do not perceive the PMBs as being valuable.

“This is primarily owing to a lack of members’ understanding, with 85% of members surveyed revealing that they do not understand their PMB entitlements, or where to access PMBs.

“The survey shows that although members in general are satisfied with the level of communication that they receive, only 45% of respondents actually read the material thoroughly.

“Most medical schemes communicate to members via booklets, annual benefit structure information or some form of electronic interface. There is a distinct lack of face-to-face communication – which has been found to yield the best results,” said Hulme.

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