BHF head in South Africa calls for affordable medical programmes
In South Africa, Katlego Mothudi, managing director of the Board of Healthcare Funders (BHF), called on the authorities to accelerate regulatory changes that would allow medical schemes to offer more affordable coverage options for lower-income households. These are low-cost benefit options (LCBOs) — programmes with a limited package of healthcare services focused on primary care.
As TimesLIVE reports, the cost of medical insurance in the country is estimated to be rising by 14–16% annually, while the medical schemes market is barely growing. Amid financial pressure, consumers are choosing cheaper options, postponing joining medical schemes, or switching to insurance products.
Services covered by LCBOs
According to Mothudi, affordable programmes would not include the full range of prescribed minimum benefits, which significantly affect the minimum cost of traditional coverage. Instead, the defined package could include consultations with general practitioners, basic medicines, laboratory and radiological tests, as well as preventive care.
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The column’s author noted that medical schemes operate on the principle of solidarity: they cannot increase contributions solely because of a client’s age or health condition. In his view, younger and healthier people moving to insurance products reduces the risk pool of medical schemes and increases pressure on the contributions paid by their members.
Regulatory dispute
According to Momentum estimates, medical insurance in South Africa already covers nearly 2 million beneficiaries. The BHF believes that LCBOs within medical schemes could expand affordable healthcare coverage to up to 10 million people.
Discussions of such programmes have continued for more than ten years: the relevant framework was considered as early as 2015. In November 2023, a report containing LCBO proposals prepared by the Council for Medical Schemes was submitted to the health minister. According to Mothudi, the minister has still not formally responded to these proposals. The BHF is challenging the situation in court while stressing that the issue should primarily be resolved through public policy.
