Medical Scheme Myths 5 January 2012 National Health Insurance Policy Brief 21

COSATU on Medical Scheme Ethnicity Statement by COSATU: “A private sector, which treats private healthcare as a business. It accounts for more than 60% of the total healthcare resources, including majority of health professionals (other than nurses), yet it serves a minority of the population, the majority of whom are white and wealthy.” In 2010, African/Black beneficiaries accounted for 46.3% of medical scheme beneficiaries. White beneficiaries accounted for only 35.7% of medical schemes, according to GHS2010. Using the “previously dis-advantaged” definition and the definition used for BEE, 64.3% of medical scheme beneficiaries fall into this category in 2010.

Ethnicity in Medical Schemes Data source: StatsSA General Household Survey 2010 (GHS 2010) Source: IMSA NHI Policy Brief 21: Medical Scheme Myths

Ethnicity in National Health Service Data source: StatsSA General Household Survey 2010 (GHS 2010) Source: IMSA NHI Policy Brief 21: Medical Scheme Myths

Ethnicity in Medical Schemes Data sources: Council for Medical Schemes, StatsSA Source: IMSA NHI Policy Brief 21: Medical Scheme Myths

Ethnicity in Medical Schemes Source: IMSA NHI Policy Brief 21: Medical Scheme Myths Data sources: Council for Medical Schemes, StatsSA

Taxpayers using Medical Expenses Deduction in 2009 Data source: National Treasury and SARS, Tax Statistics 2010 Source: IMSA NHI Policy Brief 21: Medical Scheme Myths

Taxable Income of Taxpayers using Medical Expenses Deduction Source: IMSA NHI Policy Brief 21: Medical Scheme Myths Data source: National Treasury and SARS, Tax Statistics 2010

Proportion of Population using Medical Schemes Data sources: Council for Medical Schemes, StatsSA, ASSA2008 Source: IMSA NHI Policy Brief 21: Medical Scheme Myths

Number of Medical Schemes Data source: Council for Medical Schemes Annual Reports Source: IMSA NHI Policy Brief 21: Medical Scheme Myths

Beneficiaries on Medical Schemes Data source: Council for Medical Schemes Annual Reports Source: IMSA NHI Policy Brief 21: Medical Scheme Myths

Public and Private Spend 2008 R11,300 pbpa for those belonging to medical schemes (this includes both medical scheme spending of R9,600 and estimated out-of-pocket payments of R1,700); R2,500 pbpa for the middle group (includes out-of-pocket payments to private primary care providers, and government spending on hospital care); and R1,900 pbpa for those using government primary care and hospital services. But this mixes Government spend from public money and purely private spend. Need to compare Government spend in the public sector and the subsidy from Government to the private sector. Source for figures: Health Economics Unit, UCT, Information Sheet: The Public-Private Health Sector Mix in South Africa

Public and Private Spend 2008 Data sources: Re-stated from UCT HEU, using information on subsidies from National Treasury document on proposed tax credits, June 2011 Source: IMSA NHI Policy Brief 21: Medical Scheme Myths

Public Spend in 2008 R14,518 pbpa for employer subsidy on Parmed for politicians R5,220 pbpa for employer subsidy on GEMS for public sector workers R1,600 pbpa is the Government subsidy in the form of tax relief for medical scheme membership. R1,950 pbpa for middle group (out-of-pocket payments to private primary care providers and government spending on hospital care) R1,950 pbpa for those using government primary care and hospital services. Sources: Health Economics Unit, UCT, The Public-Private Health Sector Mix in SA Council for Medical Schemes Annual Report National Treasury (2011 ). Conversion of Medical Deductions to Medical Tax Credits – Tax Policy Discussion Document for Public Comment 17 June 2011 Public Sector Bargaining Council documents. Ministerial Handbook, 2007

Innovative Medicines South Africa (IMSA) is a pharmaceutical industry association promoting the value of medicine innovation in healthcare. IMSA and its member companies are working towards the development of a National Health Insurance system with universal coverage and sustainable access to innovative research-based healthcare. Contact details: Val Beaumont (Executive Director) Tel: Fax: Innovative Medicines SA (IMSA) Cell: PO Box 2008, Houghton, South Africa

Professor Heather McLeod The New Zealand Centre for Evidence-based Research into Complementary and Alternative Medicine (ENZCAM), University of Canterbury, Christchurch, New Zealand. Extraordinary Professor, Department of Statistics and Actuarial Science, University of Stellenbosch Adjunct Professor, School of Management Studies, University of Cape Town