Risk and the South African private healthcare environment

The ability to learn from catastrophe and the science of anticipating and managing the aftermath of such events has challenged man for centuries. From its insurance origins, corporate risk management has developed into a fully fledged management function and is progressing into business areas that were originally considered unrelated. The evolution of risk management into such a corporate approach recognises that risks are interrelated and that significant benefits may be achieved from evaluating and monitoring them on a company-wide basis. The private healthcare environment today is facing pressing issues that include: • A dramatic increase in regulatory oversight within the industry; • the need for more innovative actuarial and financial models to address countrywide epidemics such as HIV and AIDS; • increased prevalence of high risk re-insurance practices which aim at ensuring the financial stability of healthcare service providers; • increases in expected fraudulent activity; • increasing the scope of private healthcare to incorporate a larger share of the South African population; and • providing effective healthcare cover to members whilst facing significant medical inflation increases