Thursday, February 29, 2024

Botswana’s Medical Insurance sector on its way to the ICU….

By Bonnie Modiakgotla

It is a tough time to be in the healthcare insurance business in Botswana as some economic developments have forced people out of their medical aids, and the prevailing conditions has made it hard to recruit new members.

Data from NBFIRA points to a sector that is under pressure, and also gives insights in how many working Batswana are without health insurance cover in the form of medical aid. NBFIRA’s figures which covers the period between 2016 and 2017 shows that principal membership of medical aid funds dropped 7.2 percent to 140,182.

The sector also recorded a reduction in total membership base (figure includes principal member’s dependents) which decreased 5.1 percent to 328,788, and the massive drop in membership has been attributed to the closing down of some mining operations as well as retrenchments by other significant employers, NBFIRA said.

An analysis of publicly available data paints a scary picture: in the period under review, about 10,815 principal members lost out on medical, taking with them about 17,611 dependents, and can be roughly be interpreted as: for every one loss of principal member, about two dependents lose out.

The latest labor statistics which covers the first quarter of the year says total employment stood at 410,692, and when you excuse the seasonal Ipelegeng employment, that figure comes to 342,771. Given the recent figure that medical aid principal membership is at 140,182 then it means about 59 percent of the workforce is without medical aid. Taken as a whole against the whole population of about 2.2 million, then about 75 percent of Batswana are without medical aid cover, either as principals or dependents.

Focus Surveys – a data analytics startup ÔÇô yesterday released this year’s survey of medical aids, in which about 1,472 individuals were sampled to get their perceptions on medical aids offering. From the respondents, about less than one third had medical aid cover, while majoring of non-subscribers expressed interest get cover. The survey shed light on what respondents expect from their medical aid providers.

The vast majority wants to get back their unused premiums either as cashback or added benefits such as health screening and gym memberships. Some are even willing to trade their health data for lower premiums. In a shocking revelation, the majority of respondents reported that they do not scrutinize their medical bills before signing them, and this behavior was mostly observed from the dependent members. Medical aid providers have raised concerns over rising fraud in the sector, and have since called on their members to help them identify fraudulent claims.


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