The medical scheme regulator’s latest industry analysis is a stark reminder that membership has become unattainable for a steadily growing slice of the population. The finger of blame must point squarely at the Council for Medical Schemes (CMS).
The number of medical scheme beneficiaries rose a mere 6% from 2011-2022, increasing from 8.53-million to 9.04-million, while the population soared 19.6%, growing from 51.8-million to 62-million people. Thus the share of the population that can afford medical scheme cover — to access a quality of services in the private healthcare sector the state can no longer reliably offer — has shrunk from 16.5% to 14.6%.
Medical scheme membership is a function of employment and fixing SA’s jobs crisis is beyond the CMS’s purview. But what it can and should do is introduce reforms to lower the cost of membership, so that more people can access private healthcare and alleviate the burden on the state.
All that is required is set out in the health market inquiry report released four years ago. But intent on cheering the governing ANC’s ideologically-driven push for National Health Insurance, the CMS has lost sight of its statutory duty to safeguard the interests of medical scheme beneficiaries.
That it has overseen such a sharp decline in the share of the population covered by medical schemes is shocking. That it has done nothing to arrest the trend is unconscionable.
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