MEDICAL aid members could pay more towards medical costs from their own pockets in future, as private hospital costs and specialists use up more medical aid premiums each year.
That's according to health economist Professor Alex van der Heever, who was reacting to the Council for Medical Schemes annual report.
According to the report released yesterday, premiums paid to medical aids amounted to R117-billion last year. Of that, R103-billion was paid out to cover members.
But each year more and more medical aid premiums go towards paying private hospitals and specialists, according to the council's registrar, Monwabisi Gantsho.
Gantsho said the increase in funds going to hospitals meant "the prices that specialists and private hospitals charge should be regulated".
- In 2012, 36,7% of premiums went to hospitals, an annual increase of 8.5% after inflation;
- 23.3% went to specialists, an annual increase of 10.3% after inflation;
- The amount of medical aid premiums spent on hospitals increased 88.2% between 2000 and 2012;
- The amount spent on specialists increased 82.9% between 2000 and 2012;
- The amount spent on GPs increased 35.6% over the past 12 years;
- But the amount spent on dentists has decreased by 17.7% since 2000.
Gantsho said the increasing percentage of premiums going towards specialists and hospitals compared with the year 2000 could not be explained because the 2012 medical aid members "were not any older and therefore not likely to be sicker than in 2000".
Van der Heever said: "There is no rational basis for the increase in costs. You can't have such a dramatic annual increase of 8% spent on hospitals, even as hospitals get new technology."
The result, said Van der Heever, was that schemes would cover less and less for members, meaning they would dig into their own pockets to fund costs.
Bonitas Medical Fund executive principal officer Dr Bobby Ramasia agreed hospital costs were "an area of concern".
The Competition Commission begins an inquiry into private healthcare costs later this month.
Ramasia said medical technology and new medicines were part of the reason that medical aids kept spending more money on specialists.
"New medical technology is expensive and there is often strong patient demand for it. As people age, their healthcare costs tend to increase dramatically."