Discovery headquarters in Sandton. Picture: SUPPLIED
Discovery headquarters in Sandton. Picture: SUPPLIED

Days before coronavirus vaccinations start in SA, medical schemes have still not agreed how and to what extent they will contribute to the cost of inoculations for people without insurance cover, industry executives have said.

SA is expecting its first 1-million doses of the AstraZeneca vaccine to land on Monday and will start immunising health workers from mid-February.

The country has been the hardest hit by the Covid-19 pandemic on the continent, with more than 1.4-million cases and more than 43,000 deaths to date.

Discovery Health said earlier in the month that medical schemes had agreed to pay above cost for vaccine doses for their members — roughly 7-million adults over 15 — thereby “cross-subsidising” procurement for another 7-million adults without private cover.

But other schemes or their administrators said the industry has not yet formally agreed those parameters and there are different views on how to proceed. More than 80% of SA’s population of roughly 60-million are not covered by medical schemes.

“The principle of cross-subsidy, we are 100% on board with, but the level ... I think needs to be discussed,” said Damian McHugh, executive head of sales and marketing at Momentum Health Solutions.

He said medical schemes are able to contribute to different extents, adding that an agreement could be reached as soon as next week. “These things move quite rapidly ... there were meetings held last night, there are meetings today,” McHugh said on Friday.

Fedhealth CEO Jeremy Yatt said the cross-subsidy proposal is legally complicated, adding, “as an industry we are very confused as to why [Discovery] is so hot to trot on this particular idea ... There are lots of governance and technical problems.”

Discovery Health said: “Uncertainty still remains around the ultimate funding arrangements ... Various iterations of models are still being discussed.”

Medshield Medical Scheme and Bonitas Medical Fund said they need more information from the government and that some details still needed to be ironed out.

Profmed said one proposal under discussion would place a greater financial burden on medical schemes than the government or companies, and alternatives should be discussed.

The National Treasury said this week that the government is still talking to medical schemes about their contribution. The government also expects businesses, such as, mining companies to chip in.



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