Bonitas: Medical schemes are expensive

Bonitas explained that there has been an increase of approximately 52% in the cost per year, per beneficiary in terms of PMB claims. It added that the proportion of PMB claims in hospitals had increased more rapidly than for services provided outside of hospitals.

The explanation Bonitas proffered for this was “upcoding” by healthcare professionals, because schemes must pay on invoice in full and that “the PMBs have made South Africans Hospicentric”. The result is that “most of our members actually end up in hospital”, which Bonitas’s representative plainly admitted “is a problem”.

Read More