AN ASSESSMENT OF THE MEDICAL AID INDUSTRY IN BOTSWANA AND THE NEED FOR MEMBER PROTECTION

Abstract

Medical aid sits in the intersection between health care and finance. It provides an essential financial tool that enables better management of medical expenses. There is a tension between the need to fulfil public health objectives while ensuring the prudential regulation of financial institutions. Therefore, for medical aid services and products to provide sufficient financial protection, it is imperative that their markets are sound and safe for members, with a robust institutional framework of Medical Aid Funds (MAF) regulation and supervision. This paper wishes to add to the growing call for more effective regulation of medical aid funds. To this end, an assessment and analysis of the extent to which members are protected will be undertaken. There is an analysis of the prevailing regulatory environment for medical aid funds. The paper argues that medical aid is a product sui generis which requires specific regulation. It provides recommendations on how this regulation will be achieved.