Thoneshan Naidoo, Principal Officer of Medshield Medical Scheme
Continuing to offer great member-centric products and services
The last 19 months have been a uniquely challenging period characterised by the COVID-19 global pandemic. Like many businesses and individuals, medical schemes found themselves in unchartered territory and had to adapt to the challenges brought on by the pandemic.
Innovation has always been a priority for Medshield. The Scheme invested significantly in their IT infrastructure, improved IT security, and made many enhancements to their member-centric digital tools to ensure more accessible and safer access to healthcare for their members.
Technology has the power to democratise healthcare. It really could enable lower healthcare costs, increase access to healthcare, and most importantly, improve the quality of healthcare. Medshield believes that technology within the right setting can be an enabling power for the South African healthcare system by bringing all of this together.
Currently, South Africa has a scarcity of skills in the healthcare sector, where the intelligent use of technology could assist. “We have to make healthcare more innovative, and that is why Medshield created SmartCare, which is a video consultation with the healthcare professional. Even in remote areas, you only need a clinic where a nurse is present. The nurse will assist with the essential check-ups and then dial up to a Family Practitioner (GP) or a specialist wherever they are in the country. All you need to bring healthcare access to remote areas is a nurse, a video tv screen monitor and a working internet connection.
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Additionally, with technological advances in medical equipment, a nurse in a remote area could position the digital stethoscope. The necessary information will feed the doctor or specialist on the screen, who can then diagnose the patient accordingly. We no longer need to refer the patient to secondary or tertiary healthcare. SmartCare enables access to quality healthcare without excessive travel times.
The COVID-19 pandemic has been a perfect illustration of just how vital membership of a medical scheme is. In 2020, Medshield’s top 10 claiming patients collectively cost the Scheme R29 million in healthcare claims. The highest claim was from a 56-year-old member with significant complications because of COVID-19. As a prescribed minimum benefit (PMB), all costs associated with a COVID-19 diagnosis were covered at the expense of approximately R7.4 million. This specific member is enrolled on Medshield’s MediValue plan at just over R2 000 per month. At his current monthly premium, it would have taken this member 300 years to pay this amount. Ultimately, this is the actual value of a medical scheme because by pooling all members’ contributions, the Scheme can afford claims of this size.
South Africans have the benefit of a world-class private medical sector. In my view, it is a national treasure and, as such, should be protected and nurtured. A public and private healthcare sector can successfully co-exist, as they have done in countries such as the UK and Australia, and there is no reason that the same should not be happening in SA.
That being said, there is no question that SA should be finding ways to supercharge NHI, given that it will benefit the country as a whole. Healthcare has a close correlation to productivity and a country’s gross domestic product. The entire country will prosper with a healthier population.
The recent COVID-19 vaccine rollout has been an excellent example of the public and private sectors successfully working together. Certainly, we are further ahead in terms of the vaccine rollout than if the government had done it alone. Covid-19 can be a terrible disease for some, and vaccinations are the only way we’re going to curb its spread. The cost of a diagnosis for a COVID-19 test is R850 – for which medical schemes cover the expense. The cost for the double dose of the Pfizer vaccination is R870, including the administrative costs. The bottom line is that the financial cost of the vaccine is insignificant when compared to the physical, emotional, social, and economic toll of COVID-19, so we must get as many people vaccinated as quickly as possible.
The continued impact of COVID-19 on the country and securing access to vaccines will remain a priority. The Scheme foresees that the constrained economic environment will further strain membership affordability, membership growth and retention well into 2022. This heightens the call for member value, which the Medshield offering will continue to enhance as a focus area.
South Africa’s economic environment poses unique challenges for the medical aid funding industry. As a result, accessing affordable private healthcare, against a backdrop of increasing unemployment rates, is increasingly becoming difficult. Since the outbreak of COVID, the need for quality financial planning and advice has suddenly become more prominent. Brokers are critical to understanding the healthcare cover offered and ensuring that the potential member is on the right plan that covers their individual needs.
With a history of over 53 years, Medshield is driven by its mission to provide access to affordable, high-quality healthcare through partnerships at very competitive prices in comparison to the market. We are confident that our member-centric business approach will continue to translate into quality healthcare and good value for money.