Anti-vaxxers could be hit in the pocket in future

As the government and the private health sector battles to cope with the soaring costs of Covid hospital treatment, especially of those who refused Covid jabs, there may come a time when anti-vaxxers are hit in their pockets.

The global science indicates clearly that those who are vaccinated are less likely to suffer servere Covid, be hospitalised or die, so they cost the medical sector less than those who are unvaccinated and fall ill.

In time, experts said, this could be reflected in insurance companies and medical aids loading premiums or cutting benefits for those who have not had the Covid jab.

Public health lawyer Safura Abdool Karim said: “At the moment, it is not ethical for medical aids to refuse to cover a patient who has not yet received the vaccine.

“However, at some point in the future, when vaccines are truly accessible for everyone, it could become constitutionally permissible for medical aids to indicate if somebody has not had their vaccination.

“There is something like a pre-existing condition and either one can be charged significantly more for premiums or some coverage could be excluded,” Abdool Karim said.

She said the issue of people taking ivermectin as a treatment or prophylactic for Covid, especially the versions formulated for farm animals, could become a major problem in the future for medical aids and insurers.

Taking ivermectin not approved for human use might lead, in future, to cover being refused, based on the illegal use of ivermectin. The situation currently is that “they are not permitted to do so”, she added.

She said medical aids could, however, change their policies to indicate they do not allow an illegal drug and refuse to cover Intensive Care Unit visits or any related medical care.

“It’s true in general if you misuse in an unprescribed way a medical aid can refuse to cover that medication,” she said.

Abdool Karim said currently there were no medical policies that stated they did not cover somebody who has used ivermectin.

Although medical services were bound by government regulation to provide treatment and pay for hospitalisations of the unvaccinated who contract Covid, this did not mean there would not be repercussions for them down the line.

Discovery Health Medical Scheme spokesperson Karishma Jivan said being vaccinated against Covid was now an additional consideration in determining life insurance premiums and benefits for new clients.

Clients who qualified would be eligible for “their maximum possible PayBack” for the first year of their new policy.

Discovery has noted those who indicated they were unwilling to be vaccinated “may, unfortunately, be subject to higher premiums due to the increased risk”.

“Refusal to be vaccinated is treated similarly to smoking or lifestyle diseases such as diabetes, which receive a higher premium.”

Dr JP van Niekerk, a trauma specialist from Pretoria, said he agreed 100% that medical aids should implement regulations.

“If you do not believe in vaccines, you do not believe in medicine as a whole and then you do not deserve any medical care,” Van Niekerk said.

However, benefit exclusion raised several issues. According to Dr Jacques Snyman, medical advisor to Health Squared Medical Scheme, medical schemes are required by law to provide comprehensive cover for all prescribed minimum benefits (PMBs).

Because Covid was classified as a PMB condition, all medical schemes were legally obliged to fund the treatment costs for members with Covid.

“This way of thinking begs a number of questions. Does this mean we now start declining cancer treatment for smokers, diabetes treatment for those who are overweight, or care for individuals who have contracted HIV?

“This would be most alarming and clearly, the ethical concerns would outweigh any such arguments,” Snyman said.

– marizkac@citizen.co.za