Discovery report shows members are living longer, but illness is becoming more complex

The HealthTrend26 report, released by Discovery Health this week, shows that death rates among Discovery Health Medical Scheme members have declined by 5.6% over the past decade. The improvement was seen across all age bands, with young adults aged 24 to 39 recording the biggest decline in death rates, at 16.3%. Members aged 75 and older saw death rates drop by 7.8%.

The report is based on clinical, lifestyle and behavioural data from more than 2.7 million members.

Dr Ron Whelan, the CEO of Discovery Health, said the improvement had been driven by earlier diagnosis, better clinical care and changes in behaviour.

“The progressions revealed in our HealthTrend26 report have not happened by accident,” said Whelan. “They reflect deliberate action across the system: earlier diagnosis, better clinical pathways and focused support encouraging members to take control of their health.”

In practical terms, this means more people are getting checked earlier, staying on treatment and managing conditions that may previously have resulted in earlier deaths.

But the flip side of living longer is an increase in your healthcare bill.

The report shows that chronic care is becoming more complex as conditions increasingly overlap. More than half of members with chronic conditions now live with multiple conditions. Cardiovascular disease, diabetes, cancer and mental health conditions are among the main drivers of chronic care demand, together accounting for 84% of total chronic spend.

One in three Discovery Health Medical Scheme members is now living with a chronic condition. Members with three or more chronic conditions make up 10% of the membership, but account for 43% of claims costs.

Whelan said many of the answers are already known: go for the screening test, take the medication, manage blood pressure, stop smoking, sleep better and move more. The harder part is getting people to act on that knowledge consistently.

The report calls this the “prevention dividend”, which is the long-term benefit of picking up risks early and acting before illness becomes more serious or more expensive.

Medical schemes to the rescue

The numbers also show the real value of medical scheme cover when something goes badly wrong.

In 2025, just 1% of Discovery Health Medical Scheme members, about 29,000 people, accounted for 33% of total healthcare spend. This amounted to R24.7-billion in claims. The top 5% of members, about 129,000 people, accounted for 63% of claims, or R46.9-billion.

The report makes the point that these are not the same people every year. A healthy person can suddenly move into this high-cost group after a car accident, cancer diagnosis, heart event or complicated surgery.

Among the high-cost examples in the report are:

🚑 A R12.7-million cardiovascular case involving long-term use of a ventilator for a 57-year-old member, who spent 105 days in hospital;
🚑 A R6-million trauma case involving a 20-year-old member, who spent 157 days in hospital; and
🚑 A R4.8-million tumour-related case for a two-year-old child, who spent 117 days in hospital.

There was also a R4.2-million case for revision of previous joint replacements for a 67-year-old member, and a R6.6-million gastrointestinal surgical case for a 39-year-old member who spent 88 days in hospital.

These examples are a painful reminder that medical aid is not only about whether your GP visit or antibiotics are paid from savings. Its biggest role is often in the event you did not budget for and could not have predicted.

Heart disease

Cardiovascular disease is at the centre of the report because it is both costly and, in many cases, shaped by risks that can be reduced.

One in five Discovery Health Medical Scheme members is living with cardiovascular disease, and cardiovascular disease accounts for 53% of scheme expenditure.

The report notes that smoking cessation can reduce cardiovascular disease risk by more than 35%, while at least 60 minutes of physical activity a week is linked to a further 25% to 30% reduction in risk.

Dr David Jankelow, a clinical cardiologist based at the Netcare Linksfield Hospital, a clinical cardiologist and former president of the South African Heart Association, said heart disease remains the biggest killer in the world and is responsible for about a third of all global deaths.

Most of these deaths are expected to happen in the developing world, with Africa facing an epidemic of cardiovascular disease.

“We need to alter this trajectory of an impending tsunami, and we better do something now,” he said.

“We spend a lot of time doing procedures on patients, giving expensive medication, but part of that is actually counselling those patients to try and change their lifestyles with aggressive risk factor modification.”

The issue extends far beyond insured lives.

“I’m not just worried about 2.7 million insured Discovery members. I’m worried about 65 million South Africans,” said Jankelow.

He referred to a South African Heart Association project screening minibus taxi drivers for heart health risks. The project focused on taxi drivers because they transport millions of South Africans every day and often work under high stress, with long hours and poor access to regular screening.

The biggest finding was that 75% of the taxi drivers screened were either overweight or obese.

Jankelow said the programme showed how small changes can be made in ordinary settings, including at taxi ranks, negating the idea that you need a gym membership to be active and healthy. The exercise advice was not complicated: walk around the taxi five times in one direction, five times in the other direction, then do squats and push-ups against the vehicle.

The importance of cancer screening tests

Cancer is another area where the data shows significant improvement. The report says cancer survival among Discovery Health Medical Scheme members has improved by 48% over the past 15 years, while life expectancy for members registered for oncology has increased by 7.1 years.

In 2025, the scheme funded R4.6-billion in cancer-related claims and paid 93% of oncology treatment costs.

Medical oncologist Dr Keorapetse Tabane said the difference between the private and public healthcare sectors is stark. In private practice, she said, many patients present with early-stage cancer. In the public sector, patients are more likely to present later, which affects survival.

“The majority of patients I see have early-stage disease. Therefore, the outcomes are better. Patients live longer. Patients are cured of cancer by simply presenting early, which then leads into the impact of screening,” she said.

Screening is one of the key reasons insured patients often have better outcomes.

“There’s a real benefit to catching patients early. The treatment is simpler; the treatment is finite; it has an end date. Whereas when patients come with more advanced disease, there are higher relapses, higher complication rates, more frequent hospitalisations, and the treatment naturally becomes more expensive,” said Tabane.

She added that prevention does not always require expensive medical intervention.

“For people to form a walking club and walk around the neighbourhood, for people to stop smoking, for people to stop drinking alcohol, for people to manage their weight, those things don’t cost anything, but the impact is so massive,” she said.

The mind shift

Mental health was another major shift point in the data.

Among Discovery Health Medical Scheme members aged 18 to 30, mental health prevalence has increased by 80% over the past decade, moving from one in 12 young adults in 2015 to one in seven in 2025. Depression remains the biggest driver of mental health claims, with 63% of mental health claimants having depression.

The rise in mental health claims may sound alarming, but the report says it also reflects improved access to care and earlier help-seeking. Admission rates for mental health conditions have declined by 11% from 2015 to 2025, suggesting that more people are getting support before their conditions become severe enough to require hospitalisation.

However, mental health cannot be treated in isolation. Members with both mental health conditions and chronic disease have much higher healthcare costs and hospital admission rates than members without both.

The key messages from the report are simple, even if the healthcare system is not:

✅ Go for a check-up before something feels wrong;
✅ Take chronic medication properly;
✅ Know your blood pressure and cholesterol numbers;
✅ Screen for cancer when you are advised to; and
✅ Do not ignore your mental health.

Better health is not only about living longer. It is about staying well enough to enjoy the years you have gained. DM