Editorial: Medical aid schemes should self-regulate through strict policing

The rising costs of medical aid hold many families in a vice-like grip: good health is always one unforeseen disaster away from evaporating into sickness or chronic illness, which can be expensive and debilitating. This is especially so in South Africa, which has a reputation worldwide for high medical costs.

Therefore, one has to be prepared.

Better-off South Africans tend to steer clear of the public health service, feeling it necessary to have the best medical aid they can afford, and that is becoming more difficult by the year.

Average annual medical aid premiums have increased by two percentage points above consumer inflation for the past 16 years. And most premiums increased by between 9% and 10% this year, with one widely used plan up by 14.9%.

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Eventually, as all too many South Africans know from bitter experience, the increased amounts on premiums outstrip salary increases, forcing people to downgrade on medical aid just as their increased age makes them more likely to depend on it.

Many young people - the healthy on whom medical aids should rely to subsidise older members - cannot afford top-notch medical aid, causing a vicious cycle in which schemes increase premiums to carry the expense of older members.

Exacerbating the problem are fraudulent or unnecessary claims - for instance to get branded sunglasses - which defeats the basic purpose of medical aid, which is to insure against disaster.

Medical aid schemes should self-regulate better through stricter policing. Luxury-oriented privileges must be cut in favour of necessities.

If medical aid schemes don't take such steps, they will price themselves out of existence, and invite intervention by the government.

The resultant burden would fall on the state, which struggles as it is, and everyone would lose.