The Council for Medical Schemes has submitted its report on affordable medical scheme options to Health Minister Dr Joe Phaahla – although the Board of Healthcare Funders (BHF) has questioned the decision.
The BHF has argued that the regulator has the authority to grant exemptions to the Medical Schemes Act and allow schemes to offer low-cost benefit option (LCBO) products right away.
Since 2015, the CMS has overseen the development of an LCBO framework that will allow cheap primary healthcare cover to be offered by medical schemes.
The report may have far-reaching implications for the sector as millions of people who cannot afford regular medical scheme membership could benefit from the products.
Medical scheme membership has hovered around the 9m mark for more than a decade, reports BusinessLIVE, with most of the public having to depend on under-resourced state hospitals and clinics, the poor state of which has been described in harrowing detail in several high-profile probes.
The BHF said the Minister was required to provide it with the report in line with a recent High Court settlement, dating back to July, when the association obtained an order compelling the minister and the CMS to provide it with all of their records on LCBOs; the Minister agreed, the CMS is challenging the ruling.
BHF head of research Charlton Murove said the potential market for LCBO products ranges from 6m to 15m people. He questioned the CMS’ decision to place the ball in the Health Minister’s court, saying the regulator has the authority to grant exemptions to the Medical Schemes Act and allow schemes to offer LCBO products right away.
Wits governance professor Alex van den Heever said: “The CMS is not an independent regulator and therefore has little interest in attempting to achieve the goals of the act.”
BusinessLIVE PressReader article – Regulator gets report on cheap options (Open access)
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CMS CEO defends ‘rogue’ outlawing of low-cost medical scheme plans
CMS to report at last on low-cost medical scheme options
Low-cost schemes will soften NHI tax burden, argue medical schemes