Don’t ditch your medical aid just yet: 4 reasons why you shouldn’t cancel your health cover

This week's signing of the National Health Insurance Bill has sent many into a tizz.Picture:

This week's signing of the National Health Insurance Bill has sent many into a tizz.Picture:

Published May 16, 2024


This week's signing of the National Health Insurance (NHI) Bill has sent many into a tizz.

The NHI, according to government, aims to provide better healthcare for all South Africans.

During the signing by President Cyril Ramaphosa on Wednesday, the Bill was described as a pivotal moment in the transformation of our country.

In a nutshell, those without medical aid will be able to access healthcare at the same facilities as those with medical aid.

Much has been said in favour for and against the NHI Bill.

However, there are still some who are unsure how the Bill impacts them and one of the Frequently Asked Questions is; "Will I have to cancel my medical aid?"

According to Health Minister, Dr Joe Phaahla, you don't have to.

Franchise Principal and Financial Adviser at Consult by Momentum, Shaun Meintjes further explains in four points why people with medical aid should not cancel their medical health cover.

"The purpose of the NHI is to make healthcare more affordable, by reducing the cost of healthcare for all. It acts like a medical aid for everyone, and South Africans will contribute to this fund through taxes and special contributions in line with what they can afford. It will ensure that everyone is entitled to free healthcare when they need it. There will be no fees charged at the health facility because the fund will cover the costs of care," he said.

He added that if it can be afforded, he strongly cautions against ditching private medical aid cover.

Four reasons why you SHOULD NOT cancel your private medical aid cover:

A worrying doctor-patient ratio: Meintjes said the current estimated ratio in the public health sector is one doctor to around 2,457 patients, while in the private health sector the estimated ratio is one doctor to 571 patients. With the introduction of NHI – and people rushing to cancel private medical health cover – these ratios might only worsen, as there remain insufficient resources to meet the needs of all South Africans.

He said there's a real risk of overburdening the system, leading to longer wait times, decreased attention to individual patients, and potentially a diminished quality of care.

Lack of clarity around what the NHI covers: "Currently, there is no clear definition of services covered by the NHI, and it appears that this definition will only be expanded on an incremental benefit and geographic basis. Because so many important aspects are still unclear, the NHI will likely take many years to be established after the Bill has passed into law," Meintjes said.

He explained that those with specialised healthcare needs may find that their treatments or procedures are not adequately covered under the NHI, especially in its early stages.

"This could result in individuals having to seek out-of-pocket payments or forgo necessary medical interventions, potentially worsening their health outcomes," he added.

Administrative complexity: According to Meintjes, the transition period from private medical schemes to the NHI may introduce administrative complexities and uncertainties. He stated that members may face challenges in accessing the same level of care they were accustomed to under their private medical schemes, especially during the initial stages of implementation.

A possible slowdown in innovation: "The potential impact on healthcare innovation and medical technology advancement is a significant concern. Private medical schemes often drive innovation by investing in cutting-edge treatments and technologies.

“With a shift towards a single-payer system like the NHI, there may be less incentive for innovation, ultimately limiting access to the latest medical advancements for South Africans," Meintjes said.

He added that there is still a great deal of uncertainty around the NHI’s roll-out, and this ambiguity is expected to persist for the near future.

“I would advise holding onto your cover while any teething pains are addressed over the coming months or possibly years, ensuring that you have access to quality healthcare when you need it,” Meintjes said.

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