---
title: "Healthcare innovation means little if people cannot afford it"
description: "Most South Africans don't think about their medical scheme every day. They think about it when the monthly contribution comes off their bank account, when increases are announced, or when they submit a claim. Yet the true value of healthcare funding is realised when life changes unexpectedly through a serious accident, a cancer diagnosis, an emergency operation or the birth of a premature baby. In those moments, the question is no longer what healthcare costs, but whether you can access the care you need and having the confidence that the treatment will be funded and you will not be left in financial difficulty."
type: "NewsArticle"
publisher: "Daily Maverick"
site: "https://www.dailymaverick.co.za"
section: "Sponsored Content"
author: "Medshield Medical Scheme"
author_url: "https://www.dailymaverick.co.za/author/medshield-medical-scheme/"
canonical_url: "https://www.dailymaverick.co.za/article/2026-11-10-healthcare-innovation-means-little-if-people-cannot-afford-it/"
published: "2026-11-10T15:39:31"
lang: "en-ZA"
word_count: 930
---

# Healthcare innovation means little if people cannot afford it

> Most South Africans don't think about their medical scheme every day. They think about it when the monthly contribution comes off their bank account, when increases are announced, or when they submit a claim. Yet the true value of healthcare funding is realised when life changes unexpectedly through a serious accident, a cancer diagnosis, an emergency operation or the birth of a premature baby. In those moments, the question is no longer what healthcare costs, but whether you can access the care you need and having the confidence that the treatment will be funded and you will not be left in financial difficulty.

By Medshield Medical Scheme · Published 10 November 2026, 17:39 SAST

## Content

For all the promise of artificial intelligence and digital transformation, I believe the biggest challenge facing healthcare today is whether people can afford to remain on a medical scheme. Unless quality healthcare remains within reach of ordinary South Africans, even the most impressive advances will have limited impact.

[Medshield’s 2027 offering](https://www.medshield.co.za?utm_source=daily_maverick&utm_medium=in_article&utm_campaign=medshield_campaign) places affordability, access and broader member support at its centre. We have kept the weighted average contribution increase to an affordable 7.9%, with 125 603 members experiencing increases of only 6% and 7%. At the same time, we have protected existing benefits, increased selected benefit limits across our options and removed or reduced co-payments to lower out-of-pocket costs. To support families, child dependants can now remain covered until age 24.

### **Affordability is reshaping healthcare**

South Africa's healthcare environment is becoming more complex every year. Households face rising costs for essentials, while healthcare inflation continues to outpace consumer inflation. Hospital tariffs and medicine prices continue to rise, and utilisation is rapidly increasing due to the growing prevalence of lifestyle diseases, cancers and because people are living longer. Medical schemes must maintain sufficient reserves to meet members’ healthcare needs and keep contributions affordable while absorbing these costs. These competing pressures are widening the gap between what healthcare costs to provide and what households can afford.

Affordability is more than a pricing discussion. It influences benefit design, provider partnerships, preventative healthcare and the way technology is deployed. The sector cannot rely indefinitely on increasing contributions to absorb rising costs. We need to deliver better healthcare while making every rand work harder for members.

Healthcare funders and providers increasingly need to contract on a value-based reimbursement model. Rather than paying healthcare providers for activity (a consultation, a procedure or a hospital admission), payment should be made on healthcare outcomes. Better healthcare is not necessarily about delivering more treatment; it is about helping people remain healthier through prevention, earlier diagnosis, coordinated care and interventions that reduce the risk of costly complications. This model benefits members while enabling medical schemes to manage long-term costs more effectively. Our 2027 benefits put this into practice through a new integrated chronic disease management programme.

### **Creating value through partnership and innovation**

Mutually beneficial partnership have consistently shaped our thinking at [Medshield](https://www.medshield.co.za?utm_source=daily_maverick&utm_medium=in_article&utm_campaign=medshield_campaign). Medical schemes need to work with healthcare providers, managed care organisations, the Council for Medical Schemes, healthcare administrators and members themselves. Members who engage in preventative care, attend routine screenings and manage chronic conditions effectively can improve their own health outcomes while contributing to a more sustainable healthcare system.

This principle also extends beyond healthcare. Healthcare decisions do not occur in isolation from the other financial pressures people face, and health and financial well-being are closely connected. Through a new distribution agreement with Sanlam, we intend to give our members and corporate clients greater access to a wider range of health and financial well-being solutions, including Sanlam Gap, Sanlam Reality and Sanlam Wealth. This collaboration allows us to broaden the conversation and bring healthcare and financial well-being solutions closer together.

Artificial intelligence, predictive analytics and digital health platforms have enormous potential to identify members at risk earlier, support preventative interventions, expand access through virtual care and streamline administrative processes. Used responsibly, these tools can improve clinical outcomes and efficiency. Their real value, however, lies in whether they make healthcare easier to access, more personalised and ultimately more affordable. That is the test we are applying in 2027 as we introduce AI-supported diabetic retinal screening across all our plans and expand access to care at home through our partners Quro and Mediclinic Hospital-at-Home.

This requires strong governance and trust. Members already have to navigate benefit structures, tariffs, provider networks and funding rules that can be difficult to understand. Technology should simplify that experience rather than add another layer of complexity. That is why, for 2027, we are giving members more ways to engage with us: a seven-day WhatsApp service with self-service options, an enhanced [Medshield](https://www.medshield.co.za?utm_source=daily_maverick&utm_medium=in_article&utm_campaign=medshield_campaign) member app with emergency assistance, and 19 new walk-in centres alongside our existing seven regional offices and walk-in centres. Equally, people deserve to understand what they are paying for and what benefits they can expect. Transparency gives members greater confidence and enables them to make more informed healthcare decisions.

### **The future must be measured by value**

Affordability, partnership, innovation and transparency ultimately come back to long-term sustainability. Sustainable healthcare is not created through a single innovation or one year's financial performance. It is built through disciplined governance, responsible financial management and consistent focus on delivering value to members.

[At Medshield](https://www.medshield.co.za?utm_source=daily_maverick&utm_medium=in_article&utm_campaign=medshield_campaign), we achieved eleven consecutive months of net membership growth during 2025, increasing principal membership by 4.5% while maintaining a solvency ratio of 53%, more than double the statutory minimum. That momentum has continued in 2026, with net growth every month to date and overall growth of 10%. We believe this growth reflects members’ increasing awareness of the extensive benefits and value they receive in return for their monthly contributions. Results like these are hard to achieve in our industry, but they also show something broader: sustainable growth remains possible when affordability, financial discipline and member value are treated as interconnected priorities.

Innovation only has value if it helps us build a healthcare system that is technologically impressive, financially inclusive and one that exists to serve the people who depend on it. The future will be defined by our ability to deliver quality care more efficiently, protect members when they are most vulnerable and ensure that healthcare remains sustainable for generations to come. **DM**

*Author: Kevin Aron, Principal Officer at Medshield Medical Scheme*