Is Fedhealth taking part in discussions to assist in securing and funding coronavirus vaccines in the country?
South Africa is participating in the WHO COVAX agreement, which aims to ensure that developing countries secure equal or at least simultaneous access to COVID-19 vaccines. S.A. does not qualify for subsidised access and the government, therefore, needed to make payment to secure access to COVID-19 vaccines via COVAX. In addition, the government is currently in negotiation to secure further vaccine supplies through bilateral deals with the relevant pharmaceutical companies. At this stage, Fedhealth specifically has not been approached by Government to participate in any talks or negotiations but the Health Funders Association (HFA) as an Industry body is representing their member schemes. Medical Aids will be an important funding mechanism for government as approximately 9 million people are covered by medical aid. By making the vaccine a Prescribed Minimum Benefit (PMB), Medical Aids will have to cover the costs of the vaccine for its members and thereby taking some of the financial burden away from government.
What are the options being considered by the company to fund and secure covid-19 vaccines in the country?
Since the primary role of a medical aid remains the funding of medical services and medication, the scheme will ensure that all members and beneficiaries are covered for the vaccine. Although it is difficult to make an accurate projection of the actual cost at this early stage due to various unknowns like the type of vaccine which the government will approve, the scheme is comfortable that it will be able to cover the cost of the COVID-19 vaccine in 2021 from risk for all its members without impacting its 2021 financial budget.
Will Fedhealth also consider putting aside funding for vaccines for non-members? And how will that work, will it be on a pro-rata basis?
A Medical Aid works on the same basis as a mutual fund and is a not-for-profit organisation. The funds, therefore, belong to the members who contribute every month through their contributions. The scheme will therefore not be able to utilise members’ money to fund vaccines for non-members without approval from members. Having said that, it must also be taken into account that other illnesses and diseases have not gone away due to COVID-19 and the scheme still needs to honour its “normal” obligations to its members. In fact, most members have delayed elective surgeries due to the pandemic and the scheme is expecting a significant increase in claims once members deem it safe again to go for these procedures. It is therefore unlikely that the scheme will be in a position to contribute to the funding of vaccines for non-members.
How many members more or less does the company have at the moment? And why is it important for the company to ensure that its members have access to vaccines?
Fedhealth currently covers 144 000 beneficiaries in total. Besides being the business of a medical scheme to look after the health of their members it is also important for medical schemes to manage costs and especially in-hospital costs which remain the largest cost driver. Therefore avoiding expensive in-hospital and ICU treatment by funding the vaccine is worth the cost of the vaccine.
Does Fedhealth believe/estimate that it could supply most of its member with vaccine access this year still? Or what is the estimated timeline?
South Africa is participating in the WHO COVAX agreement thus timelines would be dependent on this. Estimations for delivery of first vaccines to participants in the scheme is mid-2021. The scheme will then be subject to the roll-out plan recommended by the government. The hope is that all members will be able to get the vaccine before the end of 2021. From a scheme perspective, it will be important for us to be able to prioritise the higher risk members with co-morbidities.
