SA’s Prescribed Minimum Benefits (PMBs) system urgently needs reform, according to Board of Healthcare Funders (BHF) managing director Katlego Mothudi. In an interview with The Money Show he pointed out that regulations remained largely unchanged since 2003, despite major shifts in healthcare costs, treatments and disease patterns.
(PMBs were introduced to ensure medical scheme members continued receiving treatment for serious conditions after exhausting their normal benefits.)
For the past two decades no updates or changes have been made to the PMB system. and spending increased from about 40% of medical scheme budgets in 2003 to more than 60% today.
Mothudi estimated the cost at about R1,600 per beneficiary per month, meaning a family of three could face around R4,000 in costs at the lowest level.
He blamed delayed reforms partly on uncertainty surrounding the NHI, which could still take another 10 to 15 years to implement.
He said PMBs focus too heavily on hospital-based diagnosis and treatment, rather than prevention, screening and early intervention. Reforms could reduce out-of-pocket expenses, control costs and improve access to healthcare while supporting universal health coverage, said Mothudi.
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