About 70% of working South Africans have medical cover of some sort, this is according to infoQuest, a South African online research company.
This information is contained in infoQuest’s latest research on the healthcare system in South Africa. The data showed that the incidence of having medical cover is significantly higher amongst males than females.
The report revealed that access to quality healthcare remains a pressing issue in South Africa, with medical cover and the state of the nation’s hospitals at the heart of the debate.
"Despite significant strides in medical innovation and healthcare policy, a large portion of the population still faces barriers to affordable and effective care.
In November 2024, infoQuest surveyed 1000 South Africans across all demographics, to uncover their medical cover and the realities of their experiences in private and government hospitals," the group said.
The majority of respondents reported earning an income, shedding light on an urgent healthcare landscape.
The data revealed that of those who have medical cover, about half claim to have "Gap cover", which helps cover the difference between what medical schemes pay and the actual cost of care. The report also outlines the most popular medical schemes in South Africa:
The most popular medical aids are:
| Discovery Health Medical Scheme | 35% |
| Bonitas | 16% |
| GEMS (Government Employees Medical Scheme) | 15% |
| Polmed | 12% |
| Bankmed | 8% |
| Momentum Health | 6% |
| Affinity Health | 6% |
The survey results also revealed a stark difference in patient experiences between private and public hospitals.
Of the respondents, 28% had personally been admitted to hospital over the past year, while 41% had a family member admitted to hospital over the period, the report said.
According to the data, the incidence of utilising a private or government hospital is aligned with the proportion of respondents who had medical cover (eligible to be admitted to a private hospital) and those that did not have medical cover and were more likely to use a government hospital).
"As expected, there were significant differences in the rating of private versus government hospitals. Private hospitals achieved good ratings with over 80% giving a rating of 8–10 out of 10. This was significantly lower for government hospitals, with about one in three giving very poor ratings (1–4 out of 10)," it said.
The report revealed three top concerns reported by individuals who, or whose family members, had been admitted to a government hospital were:
- Long waiting times to be attended to or to be admitted.
- Inadequate facilities (eg no water, insufficient food, non-functioning medical equipment, etc).
- Unskilled or inattentive nursing staff.
"The divide between private and public healthcare services is deep, with many South Africans relying on strained public hospitals that are often overcrowded, under-resourced, and struggling to meet the growing demand.
"The National Health Insurance (NHI) stands as a potential solution to address the deep inequalities in access to medical care, however, the road to implementation is fraught with challenges, including funding constraints, concerns about the capacity of existing public healthcare infrastructure, and resistance from various stakeholders within the private sector," the report said.
Claire Heckrath, MD of infoQuest said while the NHI represents an ambitious step towards greater healthcare equity, its success will depend on effective policy implementation, a clear strategy for improving public hospitals, and the sustainable integration of private healthcare providers. "Until then, the divide between the quality of care offered in private versus public hospitals will likely remain a defining feature of South Africa's healthcare landscape, underscoring the urgent need for reform and investment in both systems,’ says Heckrath.
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