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

2. 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.

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

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

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

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

7. 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

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

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

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

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

12. 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

13. 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

14. 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

15. 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

16. 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