Pensioner's predicament highlights side-effects of changes to cross-subsidisation in med schemes

Published May 20, 1998

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Personal Finance's report on how pensioners no longer benefit from cross-subsidisation in medical schemes was prompted by a letter from a reader, Nino Mazzalupi.

As a pensioner Mr Mazzalupi found that he no longer enjoyed the same subsidisation of his medical aid contributions as pensioners on the scheme previously did.

He said younger members on the scheme no longer cross-subsidised older members as they used to when he was young and joined the scheme. This was unfair.

Mr Mazzalupi assumed that when he was old, he too would benefit from younger, working members of the scheme subsidising older members.

But rising medical inflation, an increasing number of pensioners, fewer working members and expensive new treatments have forced many medical schemes to raise the contributions of all their members - particularly pensioners who used to pay a lower contribution rate.

When they could no longer raise contributions for fear of losing more young people, many schemes stopped using the contributions of younger members to subsidise those of pensioner members.

Many pensioners find themselves in a similar predicament.

While he worked, Mr Mazzalupi had no idea what his post-retirement health care would one day cost and he did not make any provision for increasing costs.

Cross-subsidisation within medical schemes is not a written, legal agreement.

It is at best an unwritten social contract and taking civil action to claim the benefits under it will not only be costly, but may be unsuccessful.

Mr Mazzalupi is aware of the government's criticism of schemes that want to dump the old and the sickly and is waiting to see what the new legislation, the Medical Schemes Amendment Bill, will bring.

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