Alarming Number Of South Africans Do Not Have Medical Aid


Not only does south Africans suffer economic problems caused by weather and employment challenges, report from the Institute of Race Relation revealed that majority of South Africans are not covered by a medical aid.

The South African Institute of Race Relation released after its survey, that out of a population of the 54,432,000 South Africans, only 17.4% (9,458,000) of the population is medically covered – leaving about 44,974,000 people without medical coverage.

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According to the report, only 10.5% of black-African people are covered by private medical insurance, compared to 72.7% of white people prior to the time of survey.

However, Businesstech reported that there are now significantly more black-Africans (4,601,000) covered by medical aid than whites (3,317,000).

Medical aid coverage by population group, 2015

Popultion Group Total Popuplation Total Not Covered  %
African 43 645 000 38 727 000 88.7%
Coloured 4 861 000 3 912 000 80.5%
Indian/Asian 1 366 000 752 000 55.1%
White 4 561 000 1 208 000 26.5%
South African 54 432 000 44 599 000 81.9%

Stats SA last month, revealed that a majority of South Africans are yet to be covered by any type of medical aid scheme, with public facilities still being the primary choice when it comes to healthcare

Apparently, one of the biggest barriers to private healthcare in the country is the price of services and costs involved with private healthcare in the country.

Report by the Competition commission revealed that per capita spending on services like hospitals and medical specialists in South Africa increased in real terms by 40.7% and 55.7% between 2003 and 2012 – while expenditure on all health benefits by medical schemes rose by 11.1% in 2014 to reach R124.1 billion.

The Medical Aid Council of South Africa also revealed that hospital fees account for the biggest portion of what medical aid schemes pay for, taking up to 40% of total fees paid out, with specialists and medication taking up the rest.

Fraud In SA Healthcare System

Another is the prevalence of healthcare fraud involving collusion between medical aid members and healthcare providers.

Healthcare Forensic Management Unit (HFMU) of the Board of Healthcare Funders of Southern Africa (BHF), discovered that at least 7% of all medical aid claims in South Africa are fraudulent and the figure could be as high as 15%

This adds between R192 and R410 per month to every principal member’s medical aid contributions.

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Healthcare fraud is one of the leading crimes in South Africa. It is in fact, the most complex form of financial fraud to detect, monitor and prevent.