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Pay-as-you-go healthcare launches in South Africa

3 December 2010

Pay-as-you-go healthcare is now available in South Africa but, while this could provide cost savings for the man on the street, some say the quality of private health services may suffer.

In November the Yarona Healthcare Network, a company that provides network management for medical aid schemes, launched Yarona Care, the world’s first prepaid healthcare product.

The product allows customers to load a preset package of health services onto their cellphones, in the same way that airtime is loaded onto a phone. These packages can be redeemed at a general practitioner (GP) or dentist’s office. In that sense, it is similar to a cash transaction. The upside is that the services you pay for have been prenegotiated at a low rate.

Yarona’s basic package, dubbed Impilo Go, includes a 15-minute consultation, the setting of a sterile tray, nebulisation, urine dipsticks, and a course of acute medicines as prescribed by the doctor. This package costs R230.

A follow-up visit can be covered with an R80 “recharge” package. The company also offers a package that covers nurse consultation at R80, an acute medicine package which will provide seven days worth of generic medicines for R100, and a chronic medicine package which will supply a month’s worth of chronic medication for R195.

Dental packages are also on the cards ranging from a R330 package that includes an extraction or filling as well as scaling and polishing to a R2 290 package that includes consultation and work on either a crown, denture or root canal.

The service is aimed primarily at employed people who earn between R4 000 and R6 000 a month. It may also provide people who have dispersed families with a way to cover their relatives’ healthcare expenses. In the same way that people can transfer cellphone airtime, consumers can purchase vouchers for a Yarona package at a distributor nearby and then transfer the package to a relative’s cellphone by keying in a specific code on their cellphone.

The product could provide an alternative for people in low income groups, who are not covered by medical aid and also do not use state services. Domestic workers or construction workers, for example, may not be based in areas where state clinics are located and also cannot afford to spend the day waiting in queues. People employed in these sectors often see GPs on a cash basis.

GPs are somewhat skeptical of the idea. Dr Marmol Stoltz, chairperson the South African Medical Association’s (Sama’s) GP private practice committee, said that the R230 price for a consultation and medicines, offered by the Impilo Go package, “sounds extremely low”. “I don’t think you can give a quality service for that price. People can do that but they will give you a substandard package,” she said.

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