After the Bell: The great financial squeeze — a new movie coming

A rare blood disorder and life-saving treatment costing more than R6-million a year reveals the harsh financial choices facing medical aid schemes. By Stephen Grootes 3 Nov 2026 0 Illustrative 5 Dive Deeper Speed Read Summary Listen Dive Deeper I’m sure that, like me, as you wander and wonder through life, buffeted by the trials and tribulations of Grade 11 Maths and Grade 8 socialising (apparently Y is still equal to MX+C) you come across moments and dilemmas that are tailor-made to be filmed. I’m not talking about the headline-grabbing Steinhoff scandal or something completely insane like your average day in the Trump Administration.

I’m talking about the little incidents of ordinary life that make it both tough and interesting. Those moments that you possibly cuss and mutter about at the time, but give your life grit and make up your real-life story. Many of these little incidents are about choices that are almost eternal – how much would you do for your children?

Almost anything short of murder (and sometimes that…). How much would you do for your parents? (A huge amount, including having them live with you.) About once a year there is a Netflix-worthy story involving a South African medical aid scheme.

Life-saving and fund-breaking It is usually about a particular course of treatment that is, in every sense of the word, life-saving, while also being, in every sense of the phrase, fund-breaking. This morning Moneyweb published the details of a story guaranteed to have you in tears about three-and-a-half minutes after pressing the “skip intro” button on your streaming service. It concerns a 15-year-old with a rare blood disorder who can live a normal life with the right treatment.

Which just happens to cost more than R6-million a year. As it happens, this would appear to fall under the “prescribed minimum benefits” that the medical aid scheme has to pay.

If blood flows through your veins you’re obviously with the child. All of our instincts, whether you are their parent, a parent, or a human being, wants this poor child to have a normal life.

And, such is the way of things, what costs R6-million a year now will probably cost about R3-million a year in five years time and much less than that in a decade. By which stage we will all have given up on the El Niño-ravaged physical world and uploaded ourselves into the Great Augmentation anyway.

But I think you are allowed to feel more than a pang of something for the medical aid administrators. This is not a Discovery that could easily swallow that cost.

All of our other medical aid schemes are much smaller than they are. Imagine for a moment being in your later years, belonging to a relatively small fund, and wondering if it will be able to pay for the procedure you’ve been waiting for to really improve your quality of life.

Heart of the problem This really gets to the heart of our medical funding problem. The pool of people who can afford to stay in a good-quality medical aid is getting smaller, and younger people are making a financial bet that they are going to be better off without joining the fund their parents were forced to join at work.

They’re rational to do that, financially they might even be right. But if the pool of money gets too small then what can really be paid out will have to get smaller too.

It is an inconvenient fact to those who oppose National Health Insurance (NHI) that the best possible pool of funds is one that includes all of us. In cases like this there are all sorts of procedures to determine if the medical aid scheme will have to pay for the treatment.

Much of the argument in these procedures will be technical and legalistic. What does the law say?

Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with qualified healthcare professionals for medical decisions and treatment options.