South Africa: Medical Scheme Reserves - a Shot in the Arm for Mass Covid-19 Vaccination Campaign


Were it not for a much-maligned solvency policy used to regulate medical schemes 20 years ago, schemes would most likely be struggling to cover their own members for Covid-19 vaccines and be unable to fund millions of uninsured members of the public.

But this solvency policy, opposed by many schemes, has allowed a situation to develop in which the industry is now being looked to, to assist in saving the people of the country from the ravages of Covid-19 by helping to finance the acquisition and distribution of vaccines.

South Africa's medical scheme industry has been in good health in recent years: in 2018/19 the Council for Medical Schemes reported that R66-billion was held in reserves. This figure is likely to have grown significantly, taking into account the Covid-19 pandemic during which much less than normal was paid out by schemes - caused by the sudden drop in demand of non-Covid related healthcare procedures.

It was not always this way.

In 2000 and for a few years after, the industry fought a pitched and often ugly battle with regulators to avoid a major policy thrust to make schemes sustainable, restore them to solvency - and keep them solvent so they...

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