The South African Society of Anaesthesiologists (SASA) is advising South
Africans to consider the multiple factors affecting cover when choosing access
to medical care.
understands that healthcare is often hard to comprehend and expensive to
access. As a result, the Society believes, many consumers choose their medical
plans – including how much cover it offers and whether care is provided at
public or private institutions – based on the principle of “what can I afford
“The truth is,
most people look at cutting their medical costs in an effort to reduce their
household spend when they feel an economic pinch. This is a difficult decision,
since we’d all like to have access to the best facilities and treatment with
the least out of pocket costs,” says Natalie Zimmelman, CEO of the SASA.
myriad of medical care options; most making choosing the best plan for you and
your family challenging.”
options are often difficult to compare and, while it can be hard for consumers
to understand what they are covered for and what not, automatically choosing
the low-cost approach could be very expensive in the long run.
potential limitations on treatment and high co-payment responsibilities can
result when the actual costs of the treatment required is not covered by the
Consumers often have no real idea of the actual cost of
treatment when looking at the Rand value offered for that treatment within the
plan, or even if that treatment is sufficient for their individual diagnosis,
underlying conditions and health.
that consumers are often not alerted to the fact that some services, such as
anaesthesia, cannot be differentiated according to levels. An
anaesthesiologist, or any other specialist with a rare skill, will need to
provide treatment of the highest standard of skill and care, regardless of the
patient’s healthcare plan and the same treatment cannot be charged at different
created between benefits to patients and specialists’ charges often results in
the service provider ending up carrying the shortfall of the costs.
often compromised and get embroiled in administrative battles to recoup uncovered
costs from patients, putting them in bad financial positions, and spending
scarce time on administration instead of treating patients,” says Zimmelman.
In light of
the above, the SASA urges consumers to review their plans and speak to their
medical care providers to understand their cover in real detail and prevent
encourages people to make use of the Council for Medical Schemes, which
regulates medical aid schemes in South Africa and to remember that the
Competition Commission has called for individuals to make public submissions
about the state of private healthcare directly at firstname.lastname@example.org.
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