Law

The Medical Schemes Act Amendment Bill will drive up the costs of belonging to a medical scheme and deny you the opportunity of buying health insurance to supplement your medical cover, the insurance industry says. Both the long-term and the short-term insurance industries this week spelt out a number of serious repercussions for consumers if the latest round of medical legislation is implemented. Gerhard Joubert, the executive director of the Life Offices Association (LOA), says the cost of healthcare is increasing at an alarming rate for South African consumers. He says there is no doubt that the Medical Schemes Act and its regulations are the main culprits. Costs to members will continue to increase if schemes cannot prevent opportunistic scheme-hopping, impose exclusions for known pre-existing illnesses, and charge more if people join schemes only when they are already sick. If costs continue to increase, healthy people are going to opt out of medical schemes because they will not be getting value for money. The insurance industry's chief concern is that health insurance could be outlawed if the amendments are accepted. Caroline da Silva, an executive of the South African Insurance Association - which represents the short-term insurance industry - says medical schemes cannot provide for all the financial losses that you could face as a result of sickness or injury. Yet the proposed amendments stipulate that you may not buy additional cover for medical costs via health insurance. The need to keep membership affordable has resulted in many schemes cutting their benefits to retain their members. This has meant that comprehensive benefits - for example, the loss of income after an accident - are only available through supplementary cover. Da Silva says the hospital cover of millions of policyholders would become illegal if the Medical Schemes Act Amendment Bill was signed into law, as would travel insurance policies, which provide for emergency healthcare and ambulance services to travellers outside South Africa. Hospital policyholders include many old people and people who will never be medical scheme members because of their low income levels. The net effect is that the best schemes would cost more, because they offer the best benefits. These schemes would be the most attractive to members, who would inevitably claim more than they pay. To counter this, schemes would either have to increase premiums or decrease benefits, which is exactly the opposite of what the legislation sets out to achieve. (Source: Personal Finance, 4 August 2001)

AIDS will have a devastating impact on the population and the economy in the next two decades to the extent that in one province alone it could cost between R6-bn and R9-bn to sustain AIDS orphans, while the GDP could decline by up to R24-bn in the next 20 years. These were some of the unofficial figures mentioned yesterday during a Poverty Summit hosted by the executive mayor of Potchefstroom, Satish Roopa, in that city. It is predicted that, if a worst-case scenario comes to pass in terms of AIDS deaths, the North West Province would need 18 fewer schools than it has since it would have to accommodate up to 47 000 fewer children. However, there could be more than 700 000 AIDS orphans in that province alone in the years to come, which would mean a five-fold increase in the cost of sustaining them. Nationally, it has been predicted that South Africa could have a million children under the age of 15 who have lost their mothers to AIDS by the year 2005. In addition, the impact of HIV/AIDS will reverse any gains made in job creation in terms of GEAR because of the loss of skilled employees, high absenteeism and. funeral and medical costs, according to Ms Rika Van Rensburg of the North West Population Unit. One of the ways in which South African communities could cope with the effects of HIV/AIDS was by the strengthening of existing support systems in the form of extended families and communities. (Source: The Citizen, 25 July 2001)

A new programme to treat HIV/AIDS in the workplace, tested on several hundred workers at a sugar mill at Hlabisa in northern KwaZulu Natal, has yielded excellent results, with a 90 % drop in new HIV infections in one year. The programme, devised by Dr Chester Morris, assistant professor of medicine and infectious diseases at the University of British Columbia in Vancouver, has now been offered to Epicentre, a new Durban-based organisation that is involving the business sector in the fight against HIV/AIDS. Morris said more than 50% of the workers who were HIV-positive at the sugar mill came forward for voluntary AIDS testing after information about the programme was given to the workers. In addition, 90% of the workers who were HIV-positive entered into the care aspect of the programme. Morris said condom distribution at the mill increased by 400% in one year as a result of the programme and the incidence of sexually transmitted diseases declined by 90 % in one year. There was also a 90% drop in the incidence of new HIV infections. Morris said peer education was a key element of the success of the programme at Hlabisa. Central to any HIV/ AIDS policy was the necessity to link care with preventive strategies. Instead of expensive antiretrovirals, simple antibiotics had been used. He said the employees at the mill had been given hope because it had been pointed out that, while up to 30% of the workforce might have been HIV-positive, more than 60% were HIV-negative. (Source: The Star, 16 July 2001)

Managing AIDS is one of the costs of operating successfully in sub-Saharan Africa, says Afrox human resources manager Neville Goldin. Afrox is doing an actuarial study to determine the extent of HIV/AIDS in the company and the estimated costs involved in providing testing, treatment and other support services. Afrox, which did extensive AIDS education among staff during the 1980s, now markets its AIDS education packages to other companies through its external training company, HPS. Gerald Buitendach, Afrox's human resources director for Africa, says the programme will emphasise a holistic approach, with three major components: education and information, disease management and medication. Buitendach says it is difficult to move ahead with the programme until the scope of the intervention has been clarified and the financial liability for treatment has been quantified. HIV awareness is maintained through campaigns that are intended to break down misperceptions and promote a healthier lifestyle, while operations publish regular articles in newsletters. Reg Magennis of Deloitte & Touche Human Capital Corporation says that although AIDS is more prevalent among the less educated groups in the workplace, education on the disease is essential at all levels. While staff at lower levels need education on how the disease is transmitted, how to prevent it and what facilities are available for treatment, senior staff who have more influence over decisions need to be educated on legislation, about medical schemes and programmes available, about the company's disability insurance policy, funding and how to encourage disclosure. (Source: Business Day (Johannesburg), July 12, 2001, posted to the web July 12, 2001)

Daimlerchrysler South Africa, the motor manufacturer, announced on Monday, a R6 million investment in research for the development of a policy and strategy for tackling HIV/AIDS in the workplace. The project is a joint effort with the National Union of Metalworkers of South Africa (Numsa) and the German government - through the German Agency for Technical Co-operation (GTZ). DaimlerChrysler has put in R5 million, while the other R1 million came from the GTZ. Christoph Kopke, the chief executive of DaimlerChrysler SA, said the money would cover the first phase of the project, which involved training staff, traditional healers, community doctors and health workers, who would all become roleplayers. The project was aimed at DaimlerChrysler SA's 3 816 manufacturing workers, 386 workers in administration and marketing and 243 members in the parts section. There were also about 23 000 family members. Kopke said the objectives of this comprehensive and need-orientate HIV/AIDS workplace policy were to prevent further infections and to reduce stigmatisation through education programmes. It is envisaged that each HIV-positive employee or family member will receive R30 000 a year in medical assistance, including family counselling and support. (Source: Business Report, 19 June 2001)

Tax and incentives to encourage companies to take effective action against AIDS would help combat the spread of the disease across Africa, Rene Loewenson, the director of Zimbabwe's training and research support centre, said this week. However, many companies would not act unless a legal framework enforced compliance, she said. A lively debate between political and business leaders at the World Economic Forum Southern African Economic Summit drew attention to the fact that only six percent of companies, comprising major corporations, are active in fighting the pandemic, with small to medium business largely hamstrung by budgetary constraints. While the Southern African Development Community had a code of practice on AIDS and employment, she pointed out that this was hardly known at workplace level. Business has tended to see public health issues as the responsibility of governments. However, as AIDS begins to bite deep into their bottom line, the need to be proactive becomes increasingly urgent. Sub-Saharan Africa will have 85 percent of the world's 58 million AIDS cases by 2010. At a cost of between $20 and $200 a worker each year, this is an economic disaster the continent cannot sustain. At the same time HIV/ AIDS is increasing household poverty by 10 percent. (Source: Business Report, 10 June 2001)

International fuel giant British Petroleum (BP) has said it would provide anti-HIV/AIDS drugs to its employees. At the same time the petroleum firm has urged other companies it has business dealings with to take measures aimed at controlling the spread of the epidemic. BP is the second company in a space of two weeks in Botswana to announce measures to be taken to control HIV/AIDS. Debswana Diamond became the first to take a similar measure last week. Solly Molekwa, who is spearheading BP Africa's regional policy on AIDS/HIV, said the policies laid down by the Botswana government were adequate because they aimed at improving the lives of the people in the country. However, he lamented the business community's lack of commitment in addressing the problem. In Botswana one in four sexually active people is estimated to be infected. The government announced recently its plans to provide antiretroviral drugs to all HIV/AIDS patients in the country. Molekwa said BP would spend 4m in Africa this year in the drive to take care of its employees living with HIV/AIDS and their immediate families. He said it was going to spend nearly 20 000 pula in providing medical services. The company has enlisted the services of anti-HIV/AIDS activists and others, to encouraging voluntary tests and other friendly and non-discriminatory measures. (Source: Business Day, 12 June 2001)

The Mining Industry presented a proposed plan for dealing with the HIV/AIDS epidemic in the Private Sector Mining Industry....

A new survey by Old Mutual highlights the increasing costs of healthcare.

Bristol-Myers Squibb's Southern Africa general manager, Ian Strachan, said the company's two antiretroviral drugs, Zerit and Videx - would be made available at the combined price of $1 a day (about R8 a day) to both the private and public healthcare sectors, starting from Thursday.