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Friday, June 19, 2015 - 02:16
The real cure

Mark Arnold, principal officer of Resolution Health Medical Scheme (Resolution Health), an open medical schemes, says the time has come for an urgent shift in focus within the country’s healthcare sector. “There is an unhealthy obsession with curative care in our industry and among South African consumers in general. This is not only harmful to the psyche of our nation but is driving healthcare costs too high.

“We are increasingly hearing from some of our medical scheme members that there is a pressing need for more affordable products that include preventative day-to-day healthcare benefits. That is why Resolution Health strongly advocates preventative healthcare from early childhood to an advanced age. From a medical scheme perspective we have put everything in place to make it as easy as possible for our members to embrace a healthier lifestyle and a more proactive approach to their health.”
Dr Jacques Snyman, clinical advisor for Resolution Health says that this approach makes perfect sense, as research has shown time and again that providing adequate healthcare, as well as sound preventative healthcare benefits, plays a vital role in sustaining the physical, social and mental development of adults and children alike.
Preventative care is often viewed as typical lifestyle interventions such as early screening for cancer and childhood immunisations among others. While this is important, the real impact of preventative care is seen when those patients who have already been identified as suffering from a condition ensures that prevention of progress as well as prevention of another catastrophic event is in place.
Patients with specific conditions such as diabetes mellitus type 2 can ensure better disease control by adhering to their prescribed treatment plans and by having regular follow-ups with their clinicians. Patients should take ownership of their conditions and ensure disease treatment targets are discussed with their doctors and that these are actively monitored and pursued. The short and longer term outcomes of many of the typical lifestyle diseases can be significantly improved and by so doing prevent catastrophic events such as heart attacks, blindness, kidney failure and other serious diseases.
Similarly, in early preventative care strategies, defaulting on a vaccination programme during the early childhood years may have dire consequences for older children and even adults who contract perfectly preventable diseases such as measles later on in life. Providing quality healthcare plays a significant role in the overall development of children and it should therefore be a high priority for every parent. “Providing medical scheme benefits that encourage immunisation and access when it is needed therefore has an important role to play,” says Snyman.
“As a country we are dealing with a quadruple burden of disease comprising of communicable, non-communicable, perinatal and maternal, and injury-related disorders.”
Recent research undertaken by the South African Medical Journal, found that non-communicable diseases (NCDs) including heart disease, stroke, cancer, chronic respiratory diseases and diabetes have caused major damage to development and economic growth in South Africa. The accumulated losses to South Africa’s GDP between 2006 and 2015 from diabetes, stroke and coronary heart disease alone are estimated to cost the country US$1.88 billion.
Comments Snyman, “In older individuals, poor health monitoring of pre-existing healthcare conditions can often lead to additional and at times more serious healthcare problems or even injury if it is not properly managed. This can adversely impact the overall health and quality of life of older people.”
He points out that the key risk factors for NCDs are obesity, physical inactivity, smoking and eating an unhealthy diet. “Implementing quality preventative care for medical scheme members will play an essential part in healthcare cost management as well as monitoring existing illnesses and identifying conditions in their infancy.” Snyman believes that the workplace is the ideal environment in which to implement a coordinated range of interventions to encourage individuals to make specific lifestyle modifications to address health risks. This should include integrated healthcare and wellbeing programmes that place a strong emphasis on preventative care, both through medical scheme benefits and wellness interventions.”
According to Arnold, Resolution Health has dedicated itself to helping its members stay as healthy as possible. “We do so with the aid of special programmes such as Zurreal, our wellbeing and rewards programme that is aimed at encouraging individuals to embrace a healthier lifestyle through various benefits and rewards for healthy conscious behaviour.” The company has already adopted a proactive, new generation model of managed healthcare, called Patient Driven Care programme. “This continuously analyses claims, disease and behaviour patterns to timeously identify high-risk members and assign a Personal Health Coordinator (PHC) to assist the member with the management of their care.”

Copyright © Insurance Times and Investments® Vol:28.6 1st June, 2015
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