Meeting the healthcare needs of the missing middle
Healthcare costs are invariably a burden on a household income, and particularly so on the ‘missing middle’ – the low to middle income earners who cannot afford high-priced medical aid schemes on the one hand, or long hours spent waiting for treatment in state-sponsored medical facilities, clinics or hospitals on the other.
It’s this large sector of the population that has increasingly turned to products such as medical insurance to meet their healthcare needs.
Murray Hewlett, CEO of Affinity Health, says, “Medical insurance differs from medical aid in that it focuses more on major life events – those often-unforeseen events that can have a devastating impact on a family budget. Insurance may not cover pre-existing conditions, but it does cover accidental injuries, paralysis or illnesses that occur after taking out the insurance, including hospitalisation and larger procedures, at fixed amounts. In this way, medical insurance is more affordable than medical aid.”
Medical insurance is regulated by the long-term Insurance Act rather than the Council for Medical Schemes that regulates medical aids. Medical aids are obliged to provide Prescribed Minimum Benefits (PMBs), a set of defined benefits that ensure all medical scheme members have access to certain minimum health services, regardless of the options they have chosen, which contributes to increased medical aid costs.
Jasson Urbach, head of the Free Market Foundation’s healthcare policy unit, is convinced of the great value that medical insurance offers to the healthcare needs of lower income earners and suggests that efforts to change the system would be ill-advised. “The consequence of limiting the insurance sector is to immediately remove access to low cost medical care for millions. By forcing insurance companies to behave like medical aid schemes means that low cost benefit options for low to middle income earners will effectively disappear.”
Adds Hewlett, “Affinity Health’s goal is to provide this sector of the population with affordable healthcare. We have made every effort to deliver the widest range of benefits at the lowest cost through extensive research, constant development of healthcare options, in-sourcing services such as customer care and claims, building relationships with service providers such as GPs, dentists and private hospitals, always ensuring that our members know exactly what we will cover and what the shortfall will be – too many people have been made insolvent by unscrupulous operators allowing medical bills to run too high for families to cope with.”
Affinity Health is South Africa’s largest health insurance provider, with close to 175 000 lives covered, and options for Day-to-Day plans, Hospital plans, or a combination of both, or booster options. Day-to-Day cover starts at R468 and Hospital at R615. Additional special services offered by Affinity Health include a 24-hour call centre for pre-authorisations and the iER (Integrated Emergency Response) service that connects users to thousands of emergency services providers, including medical, land and sea rescue, roadside assistance, policing, private security, law enforcement, and others, through a centralised and dedicated 24-hour call centre manned by emergency trained staff.
ISSUED ON BEHALF OF AFFINITY HEALTH BY STRATEGIC PUBLIC RELATIONS. FOR FURTHER INFORMATION PLEASE CONTACT VANESSA NAUDÉ ON (011) 672-2037 or firstname.lastname@example.org