Tag: medical aid

Unemployed People Missed Out on Cancer Screenings

Source: National Cancer Institute

In a recent study, unemployed individuals in the US were less likely to have health insurance and be up to date on getting recommended cancer screening tests. Analyses published in the journal CANCER revealed that their lack of health insurance coverage completely accounted for their lower screening rates.

During the COVID pandemic, unemployment rates in the United States have risen to levels not seen since the Great Depression. To examine associations between unemployment, health insurance, and cancer screening, Stacey Fedewa, PhD, of the American Cancer Society, and her colleagues analysed information from adults under age 65 years who responded to a nationally representative annual survey of the general population.

Unemployed adults were four times more likely to lack insurance than employed adults (41.4% vs 10.0%). A lower proportion of unemployed adults had received up-to-date cervical (78.5% vs 86.2%), breast (67.8% vs 77.5%), colorectal (41.9% vs 48.5%), and prostate (25.4% vs 36.4%) cancer screening. These differences were eliminated after accounting for health insurance coverage.

“People who were unemployed at the time of the survey were less likely to have a recent cancer screening test and they were also less likely to be up-to-date with their cancer screenings over the long term. This suggests that being unemployed at a single point in time may hinder both recent and potentially longer-term screening practices,” said Dr. Fedewa. This can increase a person’s risk of being diagnosed with late-stage cancer, which is more difficult to treat than cancer that is detected at an early stage.

“Our finding that insurance coverage fully accounted for unemployed adults’ lower cancer screening utilisation is potentially good news, because it’s modifiable,” Dr Fedewa added. “When people are unemployed and have health insurance, they have screening rates that are similar to employed adults.”

The findings highlight insurance coverage’s importance in access to recommended cancer screening tests and indicate that insurance needs to be extended to all people, regardless of their employment status.

Source: Wiley

Council for Medical Schemes Recommends a Limit on Contribution Hikes

Image by Cottonbro on Pexels

In a circular sent to medical insurance schemes this week, the Council for Medical Schemes (CMS) has recommended that contribution increases be limited to 4.2% in 2022.

The regulator said that this would be in line with the projected Consumer Price Inflation (CPI) increase.

“In instances where it is economically feasible to implement a lower contribution increase than the CMS recommended CPI-linked rate, Trustees are encouraged to adopt innovative pricing models, subject to an independent actuarial evaluation,” it said.

“The CMS is also cognizant of the heightened uncertainty regarding the impact of the pandemic on healthcare claims costs, as well as how quickly member’s health-seeking behaviour will normalise.

“As such, pricing decisions for the 2022 benefit year should be largely data-dependent and sensitive to the demographic risk profile and financial position of each scheme.”

There are roughly 4 million medical scheme members, with almost 9 million beneficiaries. This represents a little more than one in seven of South Africa’s population of nearly 60 million.

Claims may spike

Some medical schemes may experience sudden spikes in high-cost claims as the pandemic progresses over coming months – though the final economic impact of the pandemic remains uncertain, the CMS said. The schemes’ demographic risk profiles, the size of the population covered, and the extent of existing cross-subsidies within benefit options or schemes will affect the impact.

Additionally, the financial position of each medical scheme prior to the pandemic will dictate how it is able to absorb high-cost claims from the pandemic, it said.

Pent-up demand

The CMS said schemes should also be cautious of pent-up demand as South Africans aim to make use of their medical aids as concerns around COVID decrease. As treatments for some minor medical conditions were postponed, with increasing vaccination rates, many of these conditions would now require more complex and expensive treatment. The CMS also noted that some healthcare services will be completely forgone, resulting in lower than projected claims costs.

“Studies also indicate that as countries move out of different Covid-19 waves, hospital visit volumes slowly recover, although the utilisation rates of different services remain well below pre-pandemic levels.”

Source: BusinessTech