Treating Covid-19 in SA is costing around R150,000 ($8,300) per person – before indirect expenses

Two months after South Africa recorded its first case of Covid-19, the cost of treating the disease is becoming clearer – though with complications for medical schemes likely to bear the brunt of the expenses.

South Africa’s second-largest medical aid administrator, Medscheme, which represents 3.8 million people, has now processed 97 claims relating to Covid-19, the Board of Healthcare Funders (BHF) said in a statement this week.

At a total cost of R14.5 million, that averages to just about R150,000 per patient.

That number includes intensive care treatment, medication, and professional fees, Medscheme says.

Testing and treatment for Covid-19 is a prescribed minimum benefit in South Africa, which means medical schemes must pay for it, regardless of the type of medical aid plan a member subscribes to.

That is roughly in line with cost estimates in some other parts of the world – although those vary wildly. Experts estimate that major insurance companies in the US can probably negotiate rates that come to the equivalent of around R110,000 per patient. Mozambique’s upper estimate for treatment comes in at the equivalent of around R55,000. In India, by one estimate, treatment could cost up to the equivalent of R85,000 per person.

With the information now at hand, South Africa’s largest closed medical scheme, the 1.8-million-member Government Employees Medical Scheme (Gems) estimates it will be spending around R900 million this year on Covid-19 treatment.

But the broader cost of the coronavirus could be trickier to estimate. South Africa has seen a 50% drop in hospital admissions since the start of lockdown, the BHF says, at least in part as people avoid seeking healthcare because they worry about picking up the SARS-CoV-2 virus.

That means savings for medical schemes – at first.

"Our biggest concern is that in instances where people are sick and do not go to hospital on time due to fear of Covid-19 infection, may lead to complications and fatalities unrelated to Covid-19 due to delayed treatment or hospitalisation," says BHF managing director. Katlego Mothudi.

"This means more people will require hospitalisation as a rebound phenomenon when the pandemic abates – and we already know that some patients on chronic medication are not adhering to treatment for fear of infection. We will soon begin to see the effects of this unfolding."

Meanwhile, Medscheme says, some medical aids have seen their reserves shrink by 10% as the bottom dropped out of markets where their money was invested.


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