The growth in healthcare costs over recent years is of concern to the medical aid funding industry.
Even though many may argue that the value of the assets that medical aid funds hold in reserve (approximately N$1,7 billion on 30 September 2022) is adequate to withstand adverse claims which may result from increased liabilities.
Medical aid funds are facing challenges: They have been spending more money on claims compared to the contributions collected over the last six months (last quarter 2022 and first quarter 2023).
The ideal ratio for funds is 85% should be spent on healthcare costs/claims, 10% on administration expenses, and 5% towards reserves/investments.
The current experience is that all medical aid funds are constantly accessing their reserves to fund healthcare benefits which is not sustainable in the medium to long term.
The medical aid funding industry lessens the burden on strained national healthcare by providing members access to state-of-the-art healthcare and allowing healthcare providers to practice their professions or offer their services.
With the increase in the number of specialist and private hospitals in Namibia, the healthcare landscape has changed, and understanding our role in slowing the growth in claims experienced involves understanding what drives healthcare costs and how to manage them effectively.
This includes understanding the relative importance of healthcare cost drivers, which, among others, include benefit design, price inflation, provider incentives, consumer demands, technological growth, etc.
THE FUTURE
The question each key player should be asking themselves is how they can help ensure the sustainability of the health funding industry?
The Namibian Association of Medical Aid Funds (Namaf) is setting strategies to ensure sustainability in the interest of all stakeholders – medical aid funds, healthcare service providers and most importantly, members of medical aids.
For their part, Namaf-registered medical aid funds have committed to work together towards finding and implementing solutions through devising industry-level interventions by entering a memorandum of understanding.
Workshops are planned for June 2023, when the funds and the management committee will set out strategies towards ensuring the future sustainability of the industry.
Namaf will also host a range of engagements through webinars to keep the industry and stakeholders abreast of interventions, which all concerned are encouraged to attend (www.namaf.org.na).
Everyone needs to understand and know their role and how they can contribute positively to ensure funding sustainability.
- Uatavi Mbai, Namibia Association of Medical Aid Funds stakeholder relations and communication manager.