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Medical aid trustees are taking members for a ride

Medical aid administrators enrich themselves, while members cannot get authorised for medical procedures, the writer says.
Medical aid administrators enrich themselves, while members cannot get authorised for medical procedures, the writer says.
Image: STOCK IMAGE

What doesn't seem to have been emphasised is how medical aid schemes have increased their administration fees.

In some cases, the medical aid schemes' administration fees are even higher than the cost of some of the healthcare providers - how can that be?

At a time when healthcare administration costs are coming down because of electronic submissions and with technology helping the medical aid schemes in reducing instances of fraud or to reduce any over-claiming, trustees' fees and related expenses are increasing unchecked.

Trustees are travelling in business class, organising fancy lunches, have luxury cars purchased by the medical aid schemes and luxury office furniture.

These are ways that the healthcare funders are legally (or illegally, as the trustees have a fiduciary duty to the members) using the members' funds to enrich themselves or to work or live in beautiful conditions at the expense of you and I, the fund members.

These administrators enrich themselves, while members cannot get authorised for medical procedures.

People who are paying for their medical aid memberships cannot get authorisations even for important procedures and important treatment because of the way the medical schemes structure the benefits.

An inquiry is needed into the administration costs and the trustees' fees and related expenses of the healthcare administrators.

Satish Dullay, Mayfair West, Johannesburg

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