Actuarial science

There is no doubt that mine workers with occupationally acquired lung diseases get a raw deal in South Africa. Their counterparts in other industries receive monthly pensions for life.

The mining industry is going to court to avoid paying nearly 30 times more in statutory levies to the compensation fund that deals with mine workers' claims for occupationally acquired lung diseases.

Estimation of mortality in South Africa has always been problematic. While reasonably accurate life tables have been computed for the Coloured, Indian and White population groups, mortality rates for the African population, and the South African population as a whole, have always been fairly approximate. Nonetheless it would appear from the official life tables and estimates of mortality derived from reconstruction of census populations that mortality in South Africa fell for many decades prior to the early to mid-1980s. Between then and the mid-1990s, rates appear to have levelled off, and even to have risen in some population groups. The release of the 2001 census data provides an opportunity to update our estimates of mortality and decide if these past trends have continued through the intercensal period and, in particular, measure whether mortality has increased in line with predictions of the impact of HIV on mortality. Since the 2001 census was run exactly five years following the first census in democratic South Africa, one can make use of information from both censuses together to provide better estimates than can be made from a single census alone. As part of the process of deriving estimates of mortality we interrogate the quality of the data, and in particular the edits performed by Statistics South Africa on the data, mainly to replace missing or dont know responses. This exercise has led us to the conclusion that, although often inconsequential in magnitude, most of the edits produced results which are inconsistent either with what might be expected or with the data that did not need editing. On the basis of these investigations, we recommend that the data be released without these edits. Further, in the case of the data on survival of children ever born we investigated various combinations of edits and assumptions but are unable to produce any sequence of proportions surviving by age of mother that is remotely plausible. Thus, very reluctantly, we are forced to conclude that these data in the 2001 census are too poor to be usable. As far as the data on adult mortality are concerned, these are used without the edits. In the case of deaths reported by household, the total numbers of deaths reported in the census by sex, population group and province were simply apportioned by age according to the age distribution of the reported deaths for which age was not imputed. In the case of the data on survival of parents, dont know and missing responses have been excluded. The method used to produce rates by population group and for the country as a whole is to apply the generalization of Brasss Growth Balance method proposed by Hill to the numbers of deaths estimated, from the population register, to have occurred between the 1996 and 2001 censuses, the estimates of the population from each of the censuses, and an estimate of the intercensal migration derived from the reconciliation of the censuses.

Promoting an environment where risk is controlled will ultimately maximise staff efficiencies.

There are fewer beneficiaries of medical schemes than a year ago, according to the latest annual report from the Council for Medical Schemes. The report, which puts into perspective the state of the industry for the financial year 2002, also said the total gross contribution income for all medical schemes increased 16.6% from 2001 to R43-billion in 2002. The number of principal members edged up 0.97%, but this comes along with a 1.8% decline in the number of dependants. The average solvency margins increased to 23.1%, higher than the required phasing-in level set at 17.5% for 2002. High solvency margins are intended to protect members and ensure coverage. The report says this represents a concerted effort to improve the financial soundness of medical schemes. Administration costs rose 15.7% from the previous year to R4.1-billion. These were far higher in restricted schemes, which rose 23.9% to R899-million, compared with open schemes, which rose 14.3% to R3.2-billion. Managed-care costs went down from R986-million in 2001 to R966-million in 2002. Fees paid to healthcare brokers rose 22.5% to R354-million, which the council attributes to members moving from scheme to scheme. New regulations on brokers came into effect at the beginning of 2003, and we are optimistic that this situation will be reversed, the report said. New legislation has reduced the rampant losses attributable to inappropriate reinsurance, said the report. Overall reinsurance losses were R297-million during the year, down 11% from 2001. It is believed that out of 50 applications for reinsurance from the registrar of medical schemes, none has been approved. Riding says there are instances where reinsurance is justified, especially for small schemes. Contributions rose 17.9% in 2002, while claims per beneficiary increased by 15.9%. Medical schemes continued to show a surplus from operations. Operating surpluses increased to R1.1-billion, the second successive year schemes enjoyed operating profits.

There are fewer beneficiaries of medical schemes than a year ago, according to the latest annual report from the Council for Medical Schemes. The report, which puts into perspective the state of the industry for the financial year 2002, also said the total gross contribution income for all medical schemes increased 16.6% from 2001 to R43-billion in 2002. The number of principal members edged up 0.97%, but this comes along with a 1.8% decline in the number of dependants. The average solvency margins increased to 23.1%, higher than the required phasing-in level set at 17.5% for 2002. High solvency margins are intended to protect members and ensure coverage. The report says this represents a concerted effort to improve the financial soundness of medical schemes. Administration costs rose 15.7% from the previous year to R4.1-billion. These were far higher in restricted schemes, which rose 23.9% to R899-million, compared with open schemes, which rose 14.3% to R3.2-billion. Managed-care costs went down from R986-million in 2001 to R966-million in 2002. Fees paid to healthcare brokers rose 22.5% to R354-million, which the council attributes to members moving from scheme to scheme. New regulations on brokers came into effect at the beginning of 2003, and we are optimistic that this situation will be reversed, the report said. New legislation has reduced the rampant losses attributable to inappropriate reinsurance, said the report. Overall reinsurance losses were R297-million during the year, down 11% from 2001. It is believed that out of 50 applications for reinsurance from the registrar of medical schemes, none has been approved. Riding says there are instances where reinsurance is justified, especially for small schemes. Contributions rose 17.9% in 2002, while claims per beneficiary increased by 15.9%. Medical schemes continued to show a surplus from operations. Operating surpluses increased to R1.1-billion, the second successive year schemes enjoyed operating profits. (Source: The Business Times, 14 September 2003). Full report: http://www.medicalschemes.com/ https://www.medscheme.co.za/medschemeonline/homepage.aspx

Men's health issued across the world are being severely neglected, a panelist taking part in a worldwide live video conference under the aegis of the World Health Organisation said on Sunday. Those taking part in the unique conference were linked to cities such as Cairo, Mumbai, Rio de Janeiro, Washington, Geneva and Addis Ababa. The Dean of the Nelson Mandela Medical School at the University of Natal in Durban, Professor Barry Kistnasamy, together with Professor Maurice Mars of the Department of Sports Science, represented the medical school on the panel. The panelist, Professor Edward Bartlett of Washington University's Public Health Department, called for the promotion of initiatives world-wide to promote men's health. He said it was anticipated that life expectancy for women in industrialised countries would soon be 90 years. Men's life expectancy, on the other hand, was nowhere near that, he said. In fact, statistics from Russia showed that the average woman there lived 15 years longer than the average man. He said that women's health initiatives were being implemented all over the world and women's issues were being widely addressed. However, programmes for men are lagging behind, Bartlett claimed. In addition, men globally were three and a half times more likely to commit suicide than women. (Source: The Daily News, 20 January 2003)

The Medical Schemes Act and its regulations are not the cost drivers of medical schemes, even though the legislation has been made the scapegoat, Patrick Masobe, the chief executive of the Council for Medical Schemes and the Medical Schemes Registrar, says. Escalating costs: The Medical Schemes Act of 1998 came into effect after a 10-year period of deregulation. During this period contribution levels escalated and dubious practices - such as basing contributions on members' risks - became rife. To single out the Act as the driver behind the high costs is to take a narrow view, Masobe says, as it conveniently chooses to ignore the cumulative years of a deregulated environment and its effects on the present scenario. Prior to the Act, schemes were never given an incentive to contain medical costs or to manage the health of their members. They were run more to benefit particular entities, and the interests of members were not paramount. Health insurance: Masobe says the council's position on the different roles of the medical scheme business and that of health insurance, as agreed with the Financial Services Board, remains unchanged. The council believes that the published amendment is consistent with that agreement. Reinsurance: The council is determined to stick to its guns on the need to examine medical schemes' reinsurance contracts. Reinsurance contracts have been abused to the detriment of many medical schemes and their members. It is also important to highlight that the council is not against reinsurance and will allow it in many cases. (Source: Personal Finance, 4 August 2001)