In a media report, the Consumer Commissioner, Ms Mamodupi Mohlala, stated that medical schemes are discriminating when imposing waiting periods on pregnant women wishing to join a medical scheme during their pregnancy.
‘The BHF finds the consumer commissioner’s statements to be misguided and damaging to the medical schemes industry as she is not portraying an accurate picture,’ read the BHF statement.
‘Medical schemes are cooperatives where members’ monies are pooled to pay for health benefits when they have been incurred by the members or when they are needed by the existing members.
‘To allow a new member onto a scheme when that member is about to undergo an expensive procedure, such as childbirth or a heart bypass or any other high-cost procedure would be discriminatory and unfair on the existing members, many of whom would have been paying contributions for most of their lives.’
The BHF claims that it would be against the principles on which medical schemes are governed to allow people to join a scheme at a time when they would be incurring healthcare related costs, and then allow them to leave the scheme directly after they had incurred those costs.
‘This scenario would very quickly deplete all funds within the scheme, leaving the existing members without any cover,’ the BHF said.
Medical schemes were originally established to protect those individuals who contributed to the system and to alleviate the burden on the state. ‘A change such as that which the Consumer Commissioner is calling for would deplete these funds and potentially bankrupt the system.’
Source: Board of Healthcare Funders
