New bill to end MPs’ medical-aid privileges

A bill will soon be introduced in parliament that would eliminate mandatory medical aid for members of parliament, which prevents them from using public healthcare services. 

By law, all members of parliament and public office bearers in South Africa are required to be members of the Parmed medical aid scheme.

This means that they never need to visit a public hospital, leaving them out of touch with the realities of South Africa’s public health system that they legislate. 

This is according to member of parliament, Dr. Kgosi Letlape, who recently announced ActionSA’s intention to table an amendment to the Parliamentary and Provincial Medical Aid Scheme Bill. 

This amendment would make the medical aid membership voluntary and not compulsory. 

“Democracy is about choice. You have the right to choose what happens to your body. When lawmakers themselves can’t make personal choices, we have a problem,” Letlape told Newsday.

Before entering politics, Letlape was the president of the Health Professions Council of South Africa and the World Medical Association, the founder of the Africa Medical Association, and the chairman of the South African Medical Association.

Letlape said this is part of ActionSA’s broader mission to make sure public representatives experience the same reality as the people they serve.  

“For too long, members of parliament and other office bearers have been shielded by a medical aid scheme exclusive to them,” he said. 

“They are insulated from the daily struggles of millions of South Africans who rely on collapsing public healthcare services.”

In a comparison between the Parmed medical aid scheme and others in South Africa, posted to the Parliamentary Monitoring Group, Parmed was found to be one of the best medical aid schemes in the country. 

Researchers from Medscheme, which manages the Parmed medical aid scheme, found that Parmed has more benefits and is cheaper than the top options on Momentum. 

Parmed’s offering is similar to the top tier of Discovery; however, Discovery members are restricted by network providers and hospital pre-authorisation, whereas Parmed is more flexible.

Parmed offers cover for more chronic conditions than any of the other medical aid schemes in the study, which included Discovery, Momentum, Fedhealth, and Bonitas. 

Office bearers insulated from ailing public healthcare

The Parliamentary and Provincial Medical Aid Scheme Act was signed into law in 1975. Because of the act’s age, no cabinet minister or body is responsible for the administration of the act. 

The last amendments to the bill predate the South African constitution, taking place in 1996.

This is not the first time that Parmed has been challenged. According to Letlape, the Economic Freedom Fighters previously took the matter to court to have Parmed abolished. 

“It was unsuccessful on the basis that court processes were not followed and the appropriate people, including legislative and judiciary members, were not consulted,” he said.

An ad hoc committee was formed to reconsider the act in 2017, on the grounds that it is “dated”.

Members of parliament were complaining that Parmed was becoming particularly expensive in 2017. 

Because it is a restricted scheme, the Registrar of the Council of Medical Schemes will not permit it to offer more than one, expensive but comprehensive benefit. 

The Ad Hoc committee explored scenarios to address this issue, including voluntary membership.

The committee concluded that if the medical aid scheme were made voluntary, too many parliamentary members would opt out due to the high costs, resulting in the collapse of the Parmed scheme.

This would prejudice not only the remaining members but retired office-bearers as well. Parmed has the highest average age of all medical aid schemes in South Africa.

The committee instead recommended that the medical aid scheme be adjusted and that the state contribute to each member’s medical aid.

It remains to be seen whether the bill will receive the required support of over 50% in the National Assembly.

The Inkatha Freedom Party (IFP) has already expressed its support for the bill, adding that it hopes this will push public representatives to strengthen and improve the public healthcare system. 

The EFF is likely to support the amendment, given the party’s previous attempts to have the bill abolished completely.

Letlape is hopeful that the amendment will successfully end compulsory membership to Parmed.

“I hope it will succeed, on the basis that I’m proposing a choice. If members of parliament see their lifestyle as more important than fixing problems in public healthcare, they can stay on Parmed,” he said. 

He said the amendment process has followed a public consultation process, which will gather information from the public, and all Parmed members, including those of the Judiciary.

Letlape will then have this input on account when ActionSA tables the amendment in the House of Parliament. 

“I am hopeful it will be successful, because otherwise it will become expensive for me, because we will have to go to court to fight for the right to choose,” he said. 

The amendment is now out for public comment. Members of the public have until September 28 to provide comments.