Quest for health

Zweli Mokgata

Zweli Mokgata

If payouts of South Africa's biggest medical aid, Discovery, are anything to go by, South Africans are stressed, depressed and fat.

Members paid a combined R1,12billion for chronic conditions through the company's chronic illness benefit, tracked through the Discovery Chronic Ailment Barometer.

Topping the list of chronic ailments was hypertension, with a total number of 157716 members complaining of the ailment.

The most expensive procedures were:

l Liver transplant at R548802;

l Long-term ventilation via tracheotomy at R448604; and

l Heart-lung transplant at R420413.

However, people paid the most for leukaemia admissions.

The highest number of hospital admissions was for Caesarean delivery. This was followed by pneumonia and whooping cough, and gastroenteritis and abdominal pain.

The Discovery Holdings Group showed a significant improvement in financial performance despite pressure on consumers when it released its annual results yesterday.

According to the company's latest health benefit tracker 2,05million people made claims during the period, at a total cost of R8,68billion (hospital costs).

Discovery recorded a 37percent increase in operating profits for the year ended on June 30 with an emphasis on managing clients through behaviour.

Adrian Gore, Discovery chief executive, said: "Vitality allows us to affect behaviour of clients by encouraging them to live healthier lifestyles through the incentives we offer. It also helped us to manage (payment) lapse rates, because healthy people lapse, sick people don't."

Despite the economies of scale that Discovery is gaining through its increasingly dominant position it charges about R91 a person a month for administration.

This is 30percent higher than the industry average of R71,50 resulting in higher premiums for consumers.

Gore justified premium levels by highlighting the rising medical costs and the company's high quality of service, compared to other administrators who were not competitive in attracting the best agents in the market. "We are trying to control medical inflation as much as we can. We project it at CPI plus three percent over the year," he said.