Medical schemes must shoulder responsibility in broadening healthcare access

April 23, 2021

Josua Joubert

Meeting new needs in challenging times

Emerging from the toughest economic year in the country since the Great Depression with a devastating 7% contraction in GDP in 2020, times are tough for South Africans. 

Josua Joubert , CEO and Principal Officer of CompCare Medical Scheme, considers how a medical scheme can broaden access to quality healthcare at this challenging moment in history. 

“For average households, affordability and lasting value have in the last year shot to the very top of the priority pile, if they were not there already. This is particularly true with regard to healthcare, which – with the ongoing impact of Covid-19 – is now more important than ever before,” he says.

Joubert points out that there remains a great deal of work to be done in ensuring the healthcare needs of all South Africans are met, but in the meantime there is a trend towards healthcare consumers doing their utmost to keep their healthcare cover intact.

“Medical schemes with a good balance of experience and foresight are addressing needs in segments of the market that have previously been overlooked. Quite simply, these individuals deserve better healthcare access. CompCare has therefore taken the stance of ‘waste not, want not’ with benefit options specifically formulated to make rands go further.

“For example, our efficiency discounted (ED) option offers exceptional value by partnering with Netcare hospitals and Dis-Chem pharmacies. This can amount to as much as 25% of the normal contribution rate for a similar plan, a difference that can, for many, make or break the decision to sign up for healthcare cover. Similarly, the majority of our preventative benefits – which provide for every stage of life – are paid from scheme risk and not from day-to-day benefits, assisting to preserve member savings more effectively,” he asserts. 

Joubert notes that flexibility is another pertinent factor when it comes to access, particularly for employer groups where one of the greatest challenges is finding the right provider to affordably cover several different staff bases without compromising on quality. “CompCare can solve this problem, with an option for everyone from the lowest-earning employee to the top-ranking executives, all within one scheme.

“And, while the ability to seek quality preventative care and treatment for one’s physical wellbeing is paramount to a good quality of life, mental health should be of equal importance. CompCare’s emotional wellness benefit, which is available free of charge on all options, provides a 24-hour helpline with trained clinical professionals, together with a referral for face-to-face counselling when required.

“As one of the country’s top-rated medical schemes, we take seriously the responsibility to provide healthcare cover that offers truly meaningful benefits for even the tightest of healthcare budgets. We pledge to continue reaching further than ever before to improve healthcare access, now and into the future,” Joubert concludes.
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Naturally, this model calls for the open participation of patients, the healthcare industry, health professionals, and the Government. “The most critical elements are robust diagnosis standards, improved access to treatment, data collection and management, co-ordination of care, measurement of outcomes and ongoing collaborative research,” du Plessis says. “We need to establish rare disease advisory committees, map gaps and opportunities, establish system requirements, create a roadmap and plan a phased implementation with clear timelines.” The RDAI states that these policy development steps would be a start in quantifying the disease burden and defining standards of care. This would be followed by building and strengthening the capacity to facilitate appropriate diagnosis, treatment, continuity and data monitoring. 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About RDAI The Rare Diseases Access Initiative (RDAI) is dedicated to advocating for improved healthcare access, policy development, and patient support for those affected by rare diseases in South Africa. The initiative brings together key healthcare stakeholders, including pharmaceutical associations, funders, genetic specialists, and patient advocacy groups, to drive impactful change. About RDSA Founded in 2013, Rare Diseases South Africa (RDSA) is a non-profit organisation advocating to ensure that people living with rare diseases and congenital disorders experience greater recognition, support, improved health service and better overall quality of life. Started out of personal need following the diagnosis of organisation founder, Kelly du Plessis' son, it became evident that there was a lack of awareness and support for rare diseases in general in South Africa. About IPASA The Innovative Pharmaceutical Association South Africa (IPASA) is a voluntary trade association representing 24 leading pharmaceutical companies committed to research, development, and innovation. Our mission is to drive healthcare advancement by advocating for policies that improve patient access to safe, high-quality, and affordable medicines.
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