Health care 'not all bad'

Johannesburg - Not all health care intermediaries are unscrupulous and offer services with no value, the Financial Intermediaries Association of Southern Africa (FIA) said on Thursday.

"While this may hold true for a very small minority of health care intermediaries, this is not the case for the majority of financial advisors in the industry who work hard to add value and offer a meaningful service to thousands of consumers" said FIA health care benefits committee chairwoman Linza van Aswegen.

She was reacting to charges to this effect by Council for Medical Schemes (CMS) registrar Patrick Matshidze.

At the release of the CMS's annual report on Wednesday, he voiced concerns about "the presence of unscrupulous medical aid brokers who render non-value services", she said.

"It is unfair to make such a generalisation and one which could mislead members of the public to believe that all intermediaries are under suspicion of poor conduct," said Van Aswegen.

"The value that the health care intermediary adds to medical scheme members and prospective members should not be underestimated," she said in a statement.

"Medical schemes are fraught with technical terminology, complex terms, limits and different benefits, a wide range of codes that are allocated to various medical procedures and many other components which only a specialist in this area will be able to interpret and explain properly."

In clarifying references by Matshidze to high broker or intermediary commissions, Van Aswegen said commission had, for several years, been regulated by the health minister.

It was limited to either R60.70 plus VAT per member per month or three percent of the monthly contributions to the scheme plus VAT - whichever amount was the lesser.

The maximum amount per member had not yet been adjusted for inflation in 2009 - an increase allowed for in the legislation.

Van Aswegen said there was a misperception that intermediaries "churn policies" to bolster their commission.

The public needed to be made aware that, when a medical scheme member transferred to another scheme, the old scheme stopped paying commission to its intermediary with payment picked up by the new scheme.

"The intermediary does not benefit financially by moving a member from one scheme to another," Van Aswegen said.

She said intermediaries were subject to a code of conduct outlined in the Financial Advisory and Intermediary Services Act. They were also regulated by CMS requirements and bound by a code of ethics.

"FIA intermediaries are committed to assisting the consumer to make informed decisions regarding medical schemes and health insurance products," she said.

- Sapa