Tailored medical cover matters in a time of rising costs
Profmed CEO, Craig Comrie, explains how a restricted scheme keeps costs lower while empowering members to take control of their health.
As South Africans face yet another wave of medical scheme increases, I want to take a moment to unpack why these adjustments happen, and why, for members of a scheme like Profmed at least, there is a meaningful difference.
Rising medical scheme prices are mainly due to what is known as ‘healthcare inflation’, which is historically 3% – 4% percentage points above traditional inflation. He says this is impacted by issues like new technology or medicines , ageing as people are living longer, fewer healthcare specialists , to name a few.
This year, Profmed’s average increase is 6.76%. In fact, for more than 74% of our members, it’s less than 7%. Compared to other open schemes, this is among the lowest increases for the second consecutive year. This isn’t just a number. It reflects the advantage of operating in a niche market, designed exclusively for South Africa’s professional community.
Being a restricted scheme means we don’t try to cover everything for everyone. We focus on what professionals need backed by superior service. This focus allows us to design benefits that are both flexible and sustainable, while keeping contributions lower and still offering comprehensive coverage where it is needed most. In a restricted environment, our members are not passive beneficiaries, they effectively direct the Scheme and are partners in a system built around shared responsibility and mutual benefit.
For professionals, health is a critical asset. Long hours, high-pressure work, and personal commitments all demand a healthcare partner that understands these realities. At Profmed, this translates into benefits that reward proactive engagement with your health, whether that’s through preventative screenings, flexible savings solutions, or gap cover to shield you from unexpected specialist costs. Members who actively manage their wellbeing contribute to a system that remains financially sustainable, which ultimately helps to keep increases lower than in open schemes.
Flexibility is also key. Life doesn’t always follow a straight path. Early-career professionals may take time off to study, pursue research, or travel. Later in life, family commitments and international opportunities shift priorities. Our modular plans, sabbatical cover, flexible savings wallet, and international benefits reflect this reality, allowing members to build a plan that grows with them without compromising their healthcare security.
The principle behind all of this is simple: by targeting a specific membership base, fostering a culture of shared responsibility, and encouraging healthy behaviors, we create a system that is resilient and responsive. Members benefit from a community that is invested in their own wellbeing, and the scheme benefits from a membership that contributes to its sustainability. It’s a win-win.
Medical scheme increases are a reality across the industry. But for those in restricted schemes like Profmed, the combination of focus, flexibility, and mutuality provides a rather powerful buffer, it helps members maintain strong coverage, take control of their health, and confidently move forward knowing that their contributions are being used wisely.
The ability to live longer and taking better care of our own healthcare needs will significantly contribute to lower overall increases in burden we place on the healthcare system . When we’re healthy, the system is less burdened. This is a recipe for more accessible and affordable healthcare.
Healthcare doesn’t have to feel transactional. By working together, sharing responsibility, and actively engaging with our health, professionals can continue to experience a scheme that truly reflects their lives, their needs, and their ambitions. That is the Profmed difference.
