Category: Medical Industry

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Opinion Piece: Medical Aid Out-of-pocket Healthcare Expenses are the Highest Ever

On By ModernMedia

14 April 2026

Photo by Towfiqu barbhuiya on Unsplash

By James White, Director: Sales and Marketing at Turnberry Management Risk Solutions

Many South Africans assume that belonging to a medical scheme means their hospital treatment will be fully covered. In practice, this is often not the case. Patients are increasingly encountering co-payments, specialist shortfalls and benefit sub-limits that leave them responsible for part of the bill. This happens because medical schemes pay according to their own tariff structures, while specialists often charge significantly more than those tariffs, sometimes as much as 500% of the scheme rate.

The difference between the scheme tariff and the provider’s invoice is then billed to the patient, and it can amount to tens of thousands of Rands. Gap cover exists specifically to address these shortfalls by covering the gap between what medical schemes pay and what healthcare providers charge, offering peace of mind and greater financial certainty.

Healthcare costs are rising faster than household incomes

Medical inflation in South Africa has consistently outpaced general inflation. While many employees receive annual increases of around four or five percent, healthcare costs often rise by nine or ten percent. Hospital tariffs, specialist fees and the cost of advanced medical technology continue to increase each year.

Medical schemes therefore face a difficult balancing act: keeping contributions affordable while managing rising provider costs. To do this, schemes increasingly rely on co-payments, tighter benefit limits and reimbursement based on scheme tariffs. For members, this means that belonging to a medical scheme does not always guarantee that every medical expense will be fully covered.

The shortfall between tariffs and specialist fees

One of the most common out-of-pocket expenses occurs when a healthcare provider charges more than the scheme rate. Medical schemes reimburse treatment according to their own tariffs, while specialists may charge several times that amount. This can create confusion for members, because policies often state that they pay “100% of the scheme rate”. In practice, this means the scheme pays up to its tariff limit, not the full amount charged by the provider.

From a gap cover perspective, this tariff shortfall accounts for the majority of claims. In many cases it represents roughly 78% to 80% of claims, making it one of the most common funding gaps patients experience.

Co-payments and sub-limits add further pressure

Shortfalls are not the only challenge patients face – medical schemes increasingly rely on co-payments and sub-limits to manage rising healthcare costs.

A co-payment is a fixed amount that the member must pay before treatment takes place. Depending on the procedure and scheme rules, these amounts can range from around R5,000 up to R30,000, and in some cases even higher. For many households, being asked to produce this amount upfront can create significant financial strain.

Sub-limits can create a similar problem. Even when a procedure is covered, schemes may limit how much they will pay for certain treatments, scans or specialist services. Once the limit is reached, the remaining cost falls to the patient.

Why adviser education matters

Because the system is complex, many clients only discover these gaps when they receive a bill after treatment. They assume their medical aid will cover the full cost of care, only to find that co-payments, benefit limits or specialist shortfalls still apply.

This is why it is important for advisers to explain clearly how medical schemes pay claims, particularly the difference between scheme tariffs and provider fees. When clients understand how these shortfalls arise, the role of gap cover becomes easier to understand. Rather than being seen as an optional extra, gap cover becomes part of the overall structure of healthcare cover alongside medical aid.

Understanding your healthcare cover before you need it

Healthcare funding in South Africa is unlikely to become less complex in the near future. As costs continue to rise, it is essential to understand how your medical scheme operates and where potential shortfalls may arise.

Many people only learn how their cover works when a claim is processed and an unexpected bill appears. Understanding the difference between scheme tariffs, provider fees, co-payments and benefit limits can help prevent these surprises.

Gap cover plays an important role in addressing these shortfalls by covering the difference between what medical schemes pay and what healthcare providers charge. Speak to a broker about what your medical aid covers, where shortfalls may occur, and how gap cover can help protect you from unexpected medical bills.

Turnberry Management Risk Solutions (Pty) Ltd is an authorised Financial Services Provider (FSP no. 36571). Underwritten by Lombard Insurance Company, an Authorised Financial Services Provider (FSP 1596) and Insurer conducting non-life insurance business.

Categories : HIV Medical IndustryTags :

Cipla Confirms Continued Support for ARV Supply Following Changes in Supplier Landscape

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Photo by Towfiqu barbhuiya

Cipla Medpro South Africa reaffirmed its commitment to ensuring the uninterrupted supply of critical antiretroviral (ARV) medicines to the Department of Health. It is essential that people living with HIV have uninterrupted access to these life-saving medicines. Any disruption of supply puts patients at risk of developing resistance to the drugs or adversely affecting health outcomes. According to Statistics South Africa, the number of people living with HIV in the country is estimated to be approximately 8 million (12,7% of the population)[1].

Recently, two suppliers who were awarded the current antiretroviral (ARV) tender, Barrs Pharmaceuticals Industries (Pty) Ltd and Innovata Pharmaceuticals (Pty) Ltd (subsidiaries of Avacare Health), have entered business rescue.

Cipla acknowledges the uncertainty this may create within the ARV supply chain and underscores its readiness to assist in maintaining stability and continuity.

Cipla has been manufacturing tenofovir/lamivudine/dolutegravir (TLD) for the government for the past 7 years, and has been one of the main suppliers of ARVs to the government for more than 12 years. Cipla has made significant investments in its local manufacturing facility, upgrading the capacity of the ARV production line with the installation of a new Countec bottle line and have increased its tablet filing capacity by 190%. The company is able to locally produce 475 million tablets annually and has upscaled its manufacturing capabilities to ensure sufficient capacity to meet current demand and support near‑term growth, while reinforcing Cipla’s commitment to secure and reliable ARV supply.

“We have mobilised resources to help maintain equitable access to quality, affordable critical medication. Cipla confirms its willingness to support national requirements under the current tender agreement and, if needed, contribute meaningfully to any supplementary procurement processes to safeguard patient access to essential treatment. We want people to live a long and healthy life as part of our commitment to caring for life,” said Paul Miller, CEO of Cipla Africa.

“In addition, we believe this tender presents an opportunity to further advance government’s commitment to strengthening local manufacturing capacity. By ensuring greater support for locally produced medicines, future allocations could meaningfully contribute to South Africa’s industrial development agenda while maintaining continuity of supply,” said Miller.

The total ARV tender is for a period of three years, and is worth an estimated R15.5bn, of which the TLD component comprises R12.6bn.

Categories : Medical IndustryTags :

Bonitas Medical Fund Revitalises Future of Healthcare in SA with New Strategic Partners

On By ModernMedia
Photo by Sora Shimazaki

The healthcare industry has evolved significantly in the past decade with innovation, improved servicing and consolidation of medical schemes emerging. Bonitas Medical Fund has taken a strategic step in responding to the needs of its members and the Health Citizens of South Africa, by appointing Momentum Health as its new administrator from 1 June 2026.

With a considerable history spanning over 4 decades, Bonitas Medical Fund has emerged as one of the leaders in the medical scheme market. Covering over 750 000 lives, the Scheme is known as the medical aid for South Africa with a range of options – strategically designed to meet the needs of South Africans from all walks of life.

The change in administration is in line with the guidelines of the Health Market Inquiry and the industry Regulator, the Council for Medical Schemes (CMS). In 2024, the CMS stated that, “one of the main issues driving market stagnation is the prevalence of ‘evergreen’ contracts”. This alludes to long-term agreements between medical schemes and suppliers spanning decades without being subject to regular competitive procurement processes.

Principal Officer, Lee Callakoppen, explains, “One of our key strategic objectives is to ensure we create value for our members and key stakeholders. This can take the form of benefit optimisation, favourable tariff negotiations, amalgamations to obtain critical mass or optimised service. The healthcare industry has evolved considerably over the past decade, and it was critical for the Scheme to evolve in line with this. Over the past 48 months, the Board have extensively debated the steps needed to be taken to place Bonitas in a competitive position and ensure that it remains sustainable in the best interest of our members. In doing so we have continuously evaluated the value provided by our service providers with consideration to our strategic objectives and the capabilities of our service providers as well as the expectations of our members corporate clients, healthcare professionals, and brokers. We have seen medical schemes placed under financial strain with sustainability challenges emerging and we remain committed to remaining relevant to our members and must therefore be vigilant in our approach.”

This was followed by rigorous ongoing benchmarking exercises and a subsequent Request for Proposal process for administrative services and managed care – with Momentum Health appointed as the successful entity for the provision of administration services and Private Health Administrators appointed to provide managed care services.

“We are delighted to cement this relationship with Momentum Health, who have demonstrated that they have the necessary capabilities to exceed expectations and support us in our strategic growth objectives” Callakoppen said. “Bonitas’ performance in the past 18 months, has exceeded all previous benchmarks with over 80 000 new families successfully enrolled on the Scheme and financial sustainability stronger than previous years. We see these appointments as strategic enablers to challenge the status quo – and drive value optimisation to continue leading the healthcare industry. Our aim is to optimise efficiencies, achieve mass enrolment, and meaningfully contribute to the shaping of private healthcare in South Africa.”

Hannes Viljoen, Chief Executive Officer of Momentum Health welcomed the appointment, citing it as a key strategic opportunity in the dynamic open market for Momentum Health. “We are excited about positively impacting the health of more people. The group currently service over 3,3 million beneficiaries in Africa and more than 25 million world-wide and are strategically and operationally positioned to deliver value in a meaningful and impactful way,” he said.

Dr Ayanda Mbuli, Chief Executive Officer of PHA, was pleased with the outcome, “We are deeply honoured by Bonitas’ decision to entrust PHA with its managed healthcare function, a historic milestone for the Scheme. This partnership presents a unique opportunity to further optimise the care received by Bonitas members and to meaningfully contribute to both the Bonitas healthcare agenda and the broader South African health landscape.”

Bonitas has been a leading open scheme in South Africa for several decades and these changes will open opportunities to build a more significant and influential open scheme that caters for more South African’s health care needs.

Categories : Expert Opinion Medical IndustryTags :

The Making of South Africa’s Medical Aid Crisis

On By ModernMedia

As of this month, South African medical aid scheme contributions have increased by between 6–9% – nearly triple the Council for Medical Schemes’ recommended 3.3% guideline. While lower than last year’s double-digit surge, the underlying problem remains: premiums keep climbing while benefit coverage keeps shrinking, exposing cracks in private healthcare that are becoming impossible to ignore.

“We’re watching private healthcare price ordinary South Africans out of the market, one annual increase at a time,” says Lungile Kasapato, CEO of PPO Serve, a healthcare management company that has been implementing value-based care in South Africa for more than a decade. “Medical schemes are caught in an impossible position – unable to control what providers charge, they’re left managing what they cover. The result is diminishing benefits, rising co-payments, and mounting out-of-pocket costs for members.”

The root of the problem lies in how healthcare is paid for. Fee-for-service, the dominant reimbursement model, rewards volume over outcomes. More tests, more procedures, more bed days – each generates revenue regardless of whether they actually improve patient health. This narrow focus fragments care and drives costs up while keeping value low.

“No amount of funding can fix a payment model that drives the wrong incentives,” Kasapato explains. “Real change requires rethinking not just what we pay for, but how we pay for it.”

Value-based care offers a fundamentally different approach: putting patients at the centre, rewarding proactive care, and linking payment directly to health outcomes. PPO Serve’s The Value Care Team demonstrates what this looks like in practice. GP-led multidisciplinary teams receive monthly, risk-adjusted payments based on patient complexity, supporting holistic care and linking meaningful incentives to measurable results. Rather than maximising billable services, providers focus on optimising patients’ overall health.

For members, this means care is no longer limited by rigid benefit caps or pre-authorisation hurdles, but structured around what genuinely enhances the efficient delivery of their care. A dedicated care coordinator guides patients through decisions made collaboratively by their GP and allied health professionals, with each team member sharing accountability for better outcomes.

But scaling models like this requires medical schemes and public funders to step up. “The challenge isn’t proving value-based care works – it’s embedding it in an infrastructure built for an entirely different system,” says Kasapato. “Claims processing, scheme administration, provider networks – every layer of private healthcare is designed with fee-for-service in mind. Transitioning to outcome-based payment means rebuilding that system and accepting the upfront investment and friction that comes with structural change. The alternative is stark: a private healthcare market that collapses under its own cost pressures, pricing out members faster than schemes can adjust. South Africa is already on that trajectory.”

“If we’re serious about universal health coverage and the long-term sustainability of the private sector, we can’t keep treating symptoms while ignoring causes,” says Kasapato. “Value-based care models are already demonstrating what’s possible. The question isn’t whether transformation is worth the investment – it’s whether we can afford to delay it any longer. The more organisations that embrace a strategic purchasing role, the greater the potential for meaningful change, not just for medical schemes but for South Africa’s healthcare system and the millions who rely on it.”

Categories : General Interest Medical IndustryTags :

Discovery Abandons R170 Million Clawback over Medicines Reimbursement Glitch

On By ModernMedia
Photo by Scott Graham on Unsplash

Discovery Health has recently abandoned its efforts to reclaim roughly R170 million from 16 507 members following a widespread administrative error in processing medical claims. This happened after the successful intervention of the advocacy group MediCheck, which argued that the affected members were being unfairly penalised for a technical glitch which they had nothing to do with.

The glitch, which happened last year, resulted in over-reimbursement of certain medicine costs that occurred throughout 2025. Several specific technical and procedural issues were involved which caused the problem to grow undetected for nearly a year, as detailed by Moonstone.

The main error was that certain claims were incorrectly reimbursed at 100% of the Discovery Health Rate, regardless of the specific benefit limits that should have applied to those categories, when they should have been reimbursed at a lower rate.

Because these claims were incorrectly reimbursed at higher rates, they were inaccurately accumulated towards members’ benefit thresholds. This caused members who had Above-Threshold Benefit (ATB) as part of their plan to reach it prematurely. Upon reaching the ATB, subsequent medical claims were funded by the scheme. Normally, these claims would have been covered by the members’ medical savings accounts or out-of-pocket contributions.

Delayed detection allowed the problem to grow. The error was particularly difficult to identify because it was a “second-order impact”. The systemic failure only became apparent late in the year when members began reaching the ATB and the financial discrepancies were finally flagged.

This snowballing error eventually affected some 16 507 members on specific Executive, Comprehensive, and Priority plans. While Discovery Health initially sought to recover these funds, ranging from thousands of rand to as much as R80 000 per member, the Council for Medical Schemes stepped in to exert pressure amid widespread media coverage of the situation. Discovery gave in and committed to refunding any recovered funds and absorbing the total financial loss itself – estimated between R130 million and R170 million.

Categories : Ageing Medical IndustryTags :

Case Study: Allmed and Tafta

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Empowering Dignified Elder Care Through Compliant, Compassionate Staffing Solutions

Photo by Matthias Zomer on Pexels

For nearly seven decades, The Association for The Aged (Tafta) has been a cornerstone of care for senior persons in Durban and surrounding communities. Its services include assisted living, frail care, home-based care, meal delivery, and essential social work and advocacy programmes, all designed to support the dignity and well-being of older persons.

Delivering this level of care consistently requires the right professional healthcare staff and strong administrative support across Tafta’s multiple facilities.

The challenge: ensuring compliance and consistency
Recruiting and managing trained Caregivers across several care units can be complex, particularly when strict compliance and accreditation standards must be met. Tafta needed a partner who could supply qualified staff while supporting operational efficiency and upholding care standards. Allmed, a specialist medical personnel solutions provider, with proven experience in healthcare staffing and administration, emerged as the ideal solution.

“At the time we were reviewing our contracts, we considered Allmed as one of the service providers to tender,” explains Yoshina Kistensamy, Divisional Manager: Operations of Tafta.

The requirements were clear: the partner needed to ensure all staff were fully compliant and accredited, while also providing responsive after-contract support. Financial flexibility was equally critical, enabling staffing to scale up or down according to operational realities without penalty.

Allmed provides layered support, with trained professionals backed by clinical facilitators, ensuring both quality care and peace of mind for residents’ families. This support is delivered across three key areas:

  • Strategic staffing: Ensures every facility has adequate, skilled personnel and optimises workforce allocation to meet varying needs.
  • Compliance oversight: Monitors adherence to healthcare standards, reducing risk and ensuring safe, consistent care practices.
  • Hands-on engagement: Provides practical support to staff and enhances day-to-day operations.

By combining these three areas, Allmed enables Tafta to operate efficiently while maintaining a strong focus on the quality and dignity of resident care.

The impact: lifting the burden, prioritising care
The partnership has given Tafta the space to focus on its core mission: providing compassionate care. By outsourcing much of its care staff, Tafta has transferred complex HR responsibilities, including training coordination, on-site supervision, and disciplinary processes, directly to Allmed.

Allmed provides layered support, with trained professionals backed by clinical facilitators, ensuring both quality care and peace of mind for residents’ families. This support is delivered across three key areas:

  • Strategic staffing: Ensures every facility has adequate, skilled personnel and optimises workforce allocation to meet varying needs.
  • Compliance oversight: Monitors adherence to healthcare standards, reducing risk and ensuring safe, consistent care practices.
  • Hands-on engagement: Provides practical support to staff and enhances day-to-day operations.

By combining these three areas, Allmed enables Tafta to operate efficiently while maintaining a strong focus on the quality and dignity of resident care.

The impact: lifting the burden, prioritising care
The partnership has given Tafta the space to focus on its core mission: providing compassionate care. By outsourcing much of its care staff, Tafta has transferred complex HR responsibilities, including training coordination, on-site supervision, and disciplinary processes, directly to Allmed.

“For us, the primary benefit lies in ensuring that our care staff remain fully compliant with all required accreditations and registrations, which supports our commitment to delivering quality care through trained professionals,” says Kistensamy. “In addition, Allmed manages the HR processes, supplementary training, and ongoing supervision for this team, allowing us to focus on expanding and strengthening care and support services for our residents and the broader eThekwini community.”

Allmed’s support goes beyond typical service agreements. They work alongside Tafta’s management and care teams. “Whether it’s a quick phone call, a WhatsApp message, or an on-site visit, Allmed is always available,” Kistensamy adds. “Knowing they are just a message away provides enormous peace of mind.”

Forging a partnership that goes above and beyond
Tafta values the partnership for more than staffing consistency. At the organisation’s annual Sports Day for older persons, Allmed has donated essential items, provided an on-site nurse, and actively participated alongside staff and residents. “It’s not just about supplying caregivers – Allmed consistently shows up and supports our programmes,” says Kistensamy.

Allmed also contributes to Tafta’s fundraising and public-relations events, including the International Day of Care and Support, golf days, resident Christmas lunches, and donor gala dinners. Their willingness to engage with staff, residents, and fellow care partners reinforces Tafta’s values and demonstrates that effective healthcare partnerships are built on the seamless alignment of the organisation, its beneficiaries, and its supporters.

Flexible solutions for non-profit needs
Agility has been a cornerstone of the Allmed–Tafta partnership. When budget pressures arose, Allmed offered alternative staffing rates without compromising service quality.

“They understand our sector and our challenges, and they work with us to make sure our residents are always cared for,” says Kistensamy. Three elements define the success of this collaboration:

  1. Exceptional customer service: proactive support and responsiveness beyond contractual obligations.
  2. Flexible staffing solutions: ability to scale services up or down based on resident needs and operational realities.
  3. Qualified, supported staff: ongoing training, supervision, and guidance ensure consistent, high-quality care.

Through this partnership, Tafta can prioritise its core mission: ensuring every resident receives compassionate, dignified care. With Allmed providing expert staffing and compliance support, the organisation can operate smoothly while maintaining high-quality care standards.

Categories : Medical IndustryTags :

Sanofi South Africa Confronts Challenge of Transformation in Healthcare

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Sanofi South Africa is proud to announce it has reached Level 1 B-BBEE status, the top rating in South Africa’s transformation framework and a rare achievement for a global healthcare company. The achievement underscores the role of global companies in driving local empowerment and healthcare access and demonstrates the potential support that multinational pharmaceuticals companies can provide in strengthening South Africa’s healthcare system.

Level 1 status recognises performance in all five B-BBEE pillars: ownership, management control, skills, supplier growth, and socio-economic development. For partners, it brings concrete benefits, including 135% procurement recognition to boost their own scorecards.

Developing people and skills
Sanofi places people at the centre of its transformation efforts. The company runs programmes for graduates, persons with disabilities, and young people through the Youth Employment Service, while also investing in management development to support career growth.

“We encourage employees to join leadership programmes that build a pipeline of diverse future leaders,” says Prudence Selani, Head of External Affairs, Sanofi South Africa. “Outside the company, Sanofi has provided interest-free loans and grants to help small businesses expand and create jobs.”

Sanofi goes beyond the B-BBEE compliance, working towards meaningful and lasting results. By the end of 2025, all Sanofi workplaces and digital platforms will be fully accessible, ensuring all employees, including those who are differently abled, can thrive. This includes new accessibility standards, assistive technology, and barrier-free workplace design through the WorkX 2.0 and Digital Accessibility standards, which guarantee full access for people with disabilities, including assistive software where needed.

Gender balance and leadership
Globally, Sanofi is ranked among the Top 25 companies for gender equality and has set clear targets for female leadership. Women already make up 50 % of the workforce, 45 % of senior leaders, and 42 % of executives. By 2025, the goal is for women to hold half of senior leadership roles and at least 40 % of executive positions.

In South Africa, this aligns with the national transformation agenda, where advancing black women into leadership is a key priority. Through targeted development and succession planning, Sanofi is increasing representation of black women in senior decision-making roles. The company also supports families through a global gender-neutral parental leave policy that gives all new parents 14 weeks of paid leave, regardless of gender or sexual orientation.

Supplier development
Expanding opportunities for black-owned and diverse suppliers is one of the biggest challenges in South Africa’s healthcare industry. Sanofi is addressing this by growing local partnerships and strengthening supply chains that support both healthcare resilience and inclusive growth.

Globally, the company has pledged to spend more than €1.5 billion with small and diverse suppliers by 2025. South Africa is already the third largest contributor to that target, showing how local progress can influence global impact.

A key example is Sanofi’s partnership with Biovac, which has expanded local vaccine manufacturing capacity and demonstrated how supplier development can drive industrial capability as well as positive public health outcomes.

“Supplier diversity is not about meeting quotas; it’s about building sustainable capability within the local economy,” says Selani. “When we strengthen local suppliers, we build a stronger healthcare system that serves South Africans for generations to come.”

Community programmes
Inequitable access to healthcare is another of South Africa’s most persistent challenges. Investing in initiatives that improve access to treatment, raise awareness of rare diseases, and support vulnerable groups across the country are key to closing these gaps.

One of the Sanofi’s largest global efforts, the €50 million A Million Conversations initiative, gives marginalised communities a platform to voice concerns and rebuild trust in healthcare. In South Africa, this commitment translates into community projects that extend treatment to more people, strengthen diagnosis and screening, and expand opportunities for healthcare education and awareness.

“You can’t transform healthcare without trust,” says Selani. “That means listening to communities, understanding their realities, and working alongside health professionals and patient groups to make care accessible where it’s needed most.”

Through collaboration with health care professionals, patients, and advocacy organisations, Sanofi aims to help build a healthcare system that is more inclusive, responsive, and trusted by all who depend on it.

“Our Level 1 B-BBEE rating is a springboard for deeper change. We plan to expand clinical research in South Africa, bring more diverse patient groups into trials, and to step up support for black-owned suppliers so they can play a bigger role in the healthcare value chain. We also want to widen access to treatments for rare diseases and immunology, areas where many patients still struggle to get the care they need,” says Selani.

Categories : Medical Industry Mental HealthTags :

Investing in Nurses Reduces Physician Burnout, International Study Finds

On By ModernMedia
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A landmark international study finds that hospitals with better nurse staffing and work environments not only benefits nurses but is significantly associated with less physician burnout and job dissatisfaction. The research, published in JAMA Network Open, provides a clear solution to the global crisis of physician burnout.

A research team, led by Penn Nursing’s Center for Health Outcomes and Policy Research (CHOPR), surveyed more than 6400 physicians and 15 000 nurses across the United States and six European countries (Belgium, England, Germany, Ireland, Norway, and Sweden). The findings show that hospitals with better nurse staffing, supportive work environments, and effective interdisciplinary teamwork had substantially lower rates of physician burnout, job dissatisfaction, and intent to leave.

“Physician burnout is a global crisis, but few actionable solutions have been identified,” said Linda H. Aiken, PhD, RN, FAAN, FRCN, Professor of Nursing and Sociology and Founding Director, CHOPR. “Our study provides evidence that investing in nurses is a ‘two-for-one’ solution – improving both nurse and physician wellbeing while also strengthening patient care.”

Key findings include:

  • In US hospitals, a modest 10% improvement in the nurse work environment including staffing adequacy was associated with a 22% reduction in physician intent to leave, a 25% reduction in physicians unwilling to recommend their hospital as a place to work, a 19% reduction in physician job dissatisfaction, and a 10% reduction in physicians experiencing high burnout.
  • In European hospitals, a 10% increase in nurse staffing adequacy was linked to 20% lower physician intent to leave, 27% lower odds of not recommending their hospital, 15% lower physician job dissatisfaction, and 12% lower odds of high burnout.
  • Hospitals with stronger physician-nurse teamwork consistently reported better physician outcomes.

The results come at a critical time, as both physicians and nurses face unprecedented levels of stress, burnout, and turnover. According to the study, 20–44% of physicians surveyed reported intentions to leave their hospital positions due to dissatisfaction, and up to 45% reported high burnout.

“These findings highlight a path forward that hospital leaders can act on immediately,” said Karen B. Lasater, PhD, RN, Chair in Nursing and Health Policy, Associate Professor, and Associate Director, CHOPR. “Improving nurse staffing and creating supportive work environments are organisational reforms that are feasible, evidence-based, and capable of retaining both nurses and physicians.”

Source: University of Pennsylvania School of Nursing

Categories : Medical IndustryTags :

FundiHealth: Quality Healthcare Now Accessible for Students

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Fundi, South Africa’s leading education finance and student solutions provider, has launched FundiHealth: a healthcare platform designed to meet the unique needs of students, young professionals and organisations committed to supporting the health and wellbeing of their people.

As part of its digital transformation and enablement strategy, Fundi has launched its own healthcare platform: FundiHealth.

Born out of Fundi’s deep understanding of the challenges students face and the recognition that health is a critical enabler of success, the platform offers affordable quality healthcare solutions for students and young professionals. “We’ve always believed that education unlocks potential, but we also see every day how poor health and the inability to afford care can derail even the most promising futures,” explains Benedict Johnson, Fundi Executive Head: EBS and New Initiatives. “Our platform was created with one clear purpose in mind: to remove healthcare as a barrier to education, productivity and meaningful participation in the economy.”

Fundi CEO Mala Suriah, moderator on the day ,Thembekile Mrototo and Fundi Executive Head Benedict Johnson at the FundiHealth launch.

The solution has been launched at a time when South Africa is grappling with a significant gap in healthcare coverage. According to the Council for Medical Schemes (2024), over 80% of South Africans do not belong to a medical aid scheme and rely entirely on the overstretched public health system. Young people are particularly vulnerable notes Charles Irumba, FundiHealth Executive: “Research from the Board of Healthcare Funders (2023) shows that fewer than 12% of students and young professionals under the age of 30 have adequate medical cover. This lack of access has serious implications not only for individual wellbeing but also for South Africa’s productivity and growth.” Data from Statistics South Africa (2024) further supports this; with absenteeism due to preventable illness costing the economy over R16 billion annually, with students and entry-level workers among the most affected.

“When students drop out of school because of untreated illnesses – including stress, depression or anxiety – or when young professionals miss work and lose income as a result, it has a detrimental effect on them as well as their families,” says Irumba. “FundiHealth ensures that young South Africans stay healthy in class and at work, contributing meaningfully to their futures and to our country’s growth and development.”

The new platform offers affordable, accessible medical cover that includes access to private doctors, medication, mental health support and preventative care services, all designed to fit the budgets of students, families and young professionals. “Critically, we’ve also created an option that allows organisations to offer their entry-level staff healthcare benefits at a fraction of the cost of traditional schemes. This is ideal for SMMEs and growing businesses, as it will assist them improve staff retention, morale and productivity,” adds Johnson. “Employers often underestimate the economic impact of poor health among their youngest and most vulnerable employees. By offering a healthcare solution like FundiHealth, they’re not just supporting their people, they’re strengthening their businesses too. Healthy employees are more engaged, more present and more productive. It’s a win-win.”

Beyond immediate productivity benefits, FundiHealth also has the potential to alleviate pressure on South Africa’s public health system by shifting some demand into the private sector and by promoting preventative care among young people. “If we want to grow as a nation, we have to keep our young people healthy in body, mind and spirit,” notes Irumba. “That’s what FundiHealth is all about. Good health is not a ‘nice-to-have’. It is a fundamental part of what it takes to succeed.”

FundiHealth is available to students, their families, young professionals and organisations at fundihealth.co.za. Customers can both explore different plan options and sign-up online.

“With FundiHealth, we’re tackling one of the most overlooked challenges to achieving one’s full potential: health. Good health underpins everything. By keeping our students and young professionals healthy, we’re keeping their dreams alive and South Africa moving forward,” Johnson concludes.

Categories : Medical IndustryTags :

Opinion Piece: The Lifetime Toll of Medical Aid Shortfalls

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Photo by Alex Green on Unsplash

By Tony Singleton, CEO at Turnberry Management Risk Solutions

21 October 2025

You plan for retirement, save for your child’s education, and try to build a financial cushion, but what happens when medical co-payments chip away at those plans, year after year? It starts small: a R5,000 co-payment for a scope. Then a few months later, a R12,000 shortfall for a hospital admission. Fast forward five years, and you’ve spent tens of thousands on out-of-pocket medical costs that your medical aid didn’t fully cover.

Medical aids cannot keep pace with the rate of medical inflation while still maintaining affordable premiums, so co-payments grow each year, more sub-limits are introduced, and specialist fees continue to outpace medical aid rates. This means more and more South Africans are finding themselves forced to draw from their retirement funds or take on debt to cover medical aid shortfalls. Medical aid alone is no longer enough to protect your financial future – gap cover has become essential.

How medical expense shortfalls silently accumulate

Medical scheme members, especially those on higher-end plans, often assume they are covered for any medical eventuality – until it is time to actually claim for a significant medical event. Even comprehensive plans can fall short when it comes to specialist charges, hospital procedures, or newer, high-tech treatments. Many specialists charge as much as five or six times the scheme rate, and certain procedures have limits to what medical aid will pay or require an up-front co-payment. While your medical aid might pay a portion, the remainder becomes your responsibility.

This can become a compounding problem. What starts as a few isolated bills adds up. Over time, shortfalls from surgeries, diagnostics, scopes, chronic illness treatment, or specialist consultations can add up to hundreds of thousands of Rands. For example, one Turnberry client managing spinal conditions, lupus, and gastro-oesophageal reflux disease (GERD) claimed R478,000 across 27 incidents in only five years. Another has claimed R450,000 across 54 incidents related to lung disease and spinal conditions, and a third, with multiple chronic issues, has received over R448,000 in gap cover payments over the same period. As the years go by, these amounts continue to add up, and this is becoming an increasingly typical pattern. Many families are forced to pause investments, take out loans, or remove money from their retirement annuities to keep up with these uncovered and unanticipated expenses.

Gap cover has become essential

Gap cover was created precisely to tackle these medical expense shortfalls, with an affordable policy that sits alongside medical aid and offers cover for medical expense shortfalls, co-payments, sub-limit cover, oncology shortfalls, prosthesis costs, and even casualty visits. Where medical aid benefits have tightened to control premiums, gap cover has expanded to fill the void.

Many South Africans still believe gap cover is a nice-to-have or something that is only necessary later in life. The reality, though, is that shortfalls affect people no matter what age they are, from broken bones in their 20s to maternity bills in their 30s or chronic conditions emerging in their 40s and beyond. Joining early also makes a difference, as you are covered from the start and your premiums will remain lower than someone beginning their cover at 65, when age-based premium increases and health exclusions may apply. Gap cover is not just for major surgeries or cancer treatments; it is valuable for more routine procedures as well as accidents and emergencies. And its value increases over time, especially if you remain continuously covered and avoid reintroducing waiting periods.

A long-term strategy, not a short-term fix

By staying on gap cover year after year, members build a stable financial buffer against the cumulative effect of medical costs. We’ve seen clients rely on gap cover for decades of health events, not just one-off emergencies, and the value of continuous cover is evident in our lifetime claims figures. Gap cover is no longer a luxury, it is an essential tool for building long-term financial resilience. Without it, medical aid shortfalls can easily undo years of careful financial planning. Talk to your broker about finding the best gap cover solution to fit your needs.

About Turnberry Management Risk Solutions

Founded in 2001, Turnberry is a registered financial services provider (FSP no. 36571) that specialises in Accident and Health Insurance, Travel Insurance, and Funeral Cover.

With extensive experience across healthcare and insurance industries in South Africa, Turnberry offers unsurpassed service to Brokers and clients. Turnberry’s gap cover products are available to clients on all medical aid schemes, as they are independently provided and are therefore transferable in the event of a change in the client’s medical aid scheme.

Turnberry is well represented nationally, with its Head Office based in Bedfordview, Johannesburg with Business Development Managers in Cape Town and Durban. The Turnberry Team’s focus on outstanding client service comes from having extensive knowledge and experience in the financial services sector and is underwritten by Lombard Insurance Company Limited. Lombard Insurance Company Limited is an Authorised Financial Services Provider (FSP 1596) and Insurer conducting non-life insurance business.