Discovery Health Medical Scheme will offer members a one-off amount of R2,500 to be used towards a disease screening benefit, using extra savings it accumulated during the Covid-19 pandemic, to encourage preventative testing under its newly launched Wellth Fund.
The scheme aims to help its members detect certain diseases early and save money that would be spent on advanced disease treatment.
Breast cancer, for example, diagnosed in stage 1 rather than stage 3 is much cheaper to treat and patients have a higher level of survival.
Screening for cancer and other diseases declined globally during pandemic as people avoided hospitals and doctors rooms. Discovery said diabetes screening and screening for breast, cervical and colon cancers has not returned to 2019 levels.
“People didn’t go and have their health checks. They didn’t go and see the doctor when they weren’t feeling well. And as a result, we're seeing more complex disease presenting with more target organ damage, with more risks for long term health,” Discovery Health CEO Ryan Noach said at the launch of the Discovery Health Medical Scheme WELLTH fund Wednesday.
“This reduction in cancer screening is really profound and worrying.”
He said the scheme members were being detected with cancer at much more advanced stages than before the pandemic. He had also heard this was what oncologists were experiencing.
Noach also noted that depression and anxiety, which had been on the increase before the pandemic had accelerated “tremendously”.
“Our data also reveals that the prevalence of mental health conditions increased 19% since 2019, too. This is largely driven by a 24% increase in prevalence of depression. We noted an uptick in psychologist and psychiatrist consultations with 36% and 12%, respectively,” Noach said.
SA medical schemes accumulated excess capital during the pandemic as people used healthcare less and avoided hospitals. This resulted in medical schemes’ solvency ratio being, on average, way in excess of what is legally required. The solvency ratio is a key metric used to gauge schemes’ claims-paying ability, as it measures the ratio of accumulated funds to gross annual contribution income.
Discovery Health Medical Scheme used its excess solvency to defer contribution increases in 2020, 2021 and 2022, improving short-term affordability for members.
It is now putting about R1.5bn into the fund, to support extensive screening and prevention for all members.
This once-off screening benefit of R2,500 or R10,000 per family for members allows for screenings for a variety of health conditions, including both physical or mental.
The benefit is unlocked if members complete or have completed a Discovery wellness check that measures blood pressure, sugar levels, cholesterol levels, weight and other risk factors for diseases such as heart disease and diabetes, among others.
Screening a population for certain cancers is well documented to come with risks and the chance of detecting problems that do not ultimately need medical treatment, but cost money to investigate.
Noach said increased screening of members would save money rather than cost the scheme. The modelling shows that for every R1 spent on screening for high cholesterol, high blood pressure and diabetes, R9 could be saved on treatment costs if some diseases are detected early and treated.
The modelling also showed that for every R1 spent on diabetic screening, the scheme has the potential to save R4 in reduced long-term healthcare costs — if the screening of at-risk members is followed by appropriate interventions to manage this risk of developing diabetes.
He said screening and preventative healthcare had multiple benefits.
“The dividend the society gets is a healthier society. The dividend the scheme gets is lower health costs.”
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