

National Health Insurance Provincial Medical Scheme Coverage Download full PDF Document At a provincial level the proportion of the population covered by medical schemes is less certain. The graph below contrasts the StatsSA General Household Survey 2005 (GHS2005) figures with those derived from the Council for Medical Schemes with the ASSA2003 provincial population for 2005. Figure 3: Comparison of Provincial Medical Scheme Coverage from StatsSA and derived from Council for Medical Schemes with ASSA2003 Population The graph shows that the Western Cape and South Africa estimates are reasonably close from the two sources. Given that the StatsSA source is a survey, the differences for the Western Cape and South Africa are not meaningful. Of greater concern and interest is the very large difference reported for Gauteng. There are several possible reasons: The StatsSA figures are from a survey of only some 30,000 households. The extent of the difference in such a large province seems to be something more than the uncertainty from a survey. The quality of the Council for Medical Schemes data at a provincial level is untested. It is suspected that not all administrators deal with this in the same way and it is unlikely that they are reporting the province where the beneficiaries live. For some employers, all the workers and their families may have been allocated to the province of the head office which is more likely to be Gauteng. Where the administrator has postal code information on the member, the whole family is probably recorded as being at the same address. Schemes are unlikely to keep postal code information on beneficiaries. Thus the whole family may be recorded as being in Gauteng when only the main member, the worker, is based there. This is reinforced by the information in Policy Brief 1 that the Gauteng age and gender profile is skewed heavily towards young working age men and has lower numbers of women and children, compared to nearby provinces. The Council for Medical Schemes does not publish provincial profiles by age and gender, but only the total numbers of members and beneficiaries. GHS2005, while only being a survey, may have better information on where the beneficiaries are located than the CMS data. Research is needed to produce authoritative age-gender profiles for medical schemes and bargaining council schemes at a national and provincial level. << Back to NHI Project List	Contact Details: Innovative Medicines SA Val Beaumont P.O. Box 2008 Houghton, 2041 Tel: +27 11 880-4644 Fax: +27 11 880-5987 Contact Us! Corporate Social Responsibility Projects of IMSA Member Companies Copyright / Disclaimer

National Health Insurance
Provincial Medical Scheme Coverage

At a provincial level the proportion of the population covered by medical schemes is less certain. The graph below contrasts the StatsSA General Household Survey 2005 (GHS2005) figures with those derived from the Council for Medical Schemes with the ASSA2003 provincial population for 2005.

Figure 3: Comparison of Provincial Medical Scheme Coverage from StatsSA and derived from Council for Medical Schemes with ASSA2003 Population

The graph shows that the Western Cape and South Africa estimates are reasonably close from the two sources. Given that the StatsSA source is a survey, the differences for the Western Cape and South Africa are not meaningful. Of greater concern and interest is the very large difference reported for Gauteng. There are several possible reasons:

The StatsSA figures are from a survey of only some 30,000 households. The extent of the difference in such a large province seems to be something more than the uncertainty from a survey.
The quality of the Council for Medical Schemes data at a provincial level is untested. It is suspected that not all administrators deal with this in the same way and it is unlikely that they are reporting the province where the beneficiaries live.

For some employers, all the workers and their families may have been allocated to the province of the head office which is more likely to be Gauteng.
Where the administrator has postal code information on the member, the whole family is probably recorded as being at the same address. Schemes are unlikely to keep postal code information on beneficiaries.
Thus the whole family may be recorded as being in Gauteng when only the main member, the worker, is based there. This is reinforced by the information in Policy Brief 1 that the Gauteng age and gender profile is skewed heavily towards young working age men and has lower numbers of women and children, compared to nearby provinces.

The Council for Medical Schemes does not publish provincial profiles by age and gender, but only the total numbers of members and beneficiaries. GHS2005, while only being a survey, may have better information on where the beneficiaries are located than the CMS data. Research is needed to produce authoritative age-gender profiles for medical schemes and bargaining council schemes at a national and provincial level.

<< Back to NHI Project List

Contact Details:

Innovative Medicines SA
Val Beaumont

P.O. Box 2008
Houghton, 2041

Tel: +27 11 880-4644

Fax: +27 11 880-5987

Corporate Social Responsibility Projects of IMSA Member Companies

National Health Insurance Provincial Medical Scheme Coverage

Contact Details:

National Health Insurance
Provincial Medical Scheme Coverage