"Nostalgia? not what it used to be," goes the old truism. The same could be said of medical aid, of course: the healthcare landscape has changed rapidly and dramatically over the last five years ?for the worse, some would say.

First, the bad news.

The chief change, from the perspective of the consumer, is that medical aid now seems to cost more and cover less. Choosing to dispute this means that you risk insulting those feeling the pain ?it's a bit like saying, ?ome on, it? not so bad!?to someone writhing in agony on a hospital bed.

Medical aid used to be an umbrella: you, with the help of an employer, paid what seemed a manageable premium, and in return you got total coverage. Today medical aids are more like partners in personal health financing.

That? the bad stuff. However, some change is for the better.

Medical aids today treat members as responsible adults (and expect responsible behaviour in return, of course). Previously, medical aids and doctors regarded themselves as powerful parental figures and were treated accordingly, while members and patients were regarded as infants in need of guidance. Nowadays, a relationship of mutual respect has replaced this.

Today members are considered able and bound to make their own health decisions and manage their medical costs on the basis of the information provided. The ruling assumption is that the individual member is best placed to decide about his or her own health and to find the right support.

Another change is that medical aids are becoming better geared to supporting members over time. They are toughly regulated, their operations are more businesslike, and many have built strong reserves against calamity.

What does this mean for members?

The advantages of these changes for members are obvious, and so are some of the disadvantages. Chief of these is the loss of humane concern for personal health. Although the trend of businesslike organisation means that medical aids may pay on time, this way of operating often involves treating members as units. Medical aids may provide the information needed for informed decisions, but concern is often lacking. Members are able to get certain information more easily, but the other side of the coin is that the call centre setup stops you from really "talking" to the medical aid.

From Cape Medical Plan's viewpoint...

We understand that health issues are saturated in anxiety, and our view is that efficiency and human contact are not mutually exclusive. This is why ex-nurses feature prominently in our relationship with our members, and why Cape Medical Plan is member-owned and remains at an intimate size. Our staff are professional Cape Medical Plan people, not professionals working for Cape Medical Plan ?their commitment is to members.

More than just financial assistance

Our staff know and are expected to be informed about medical conditions and treatment. They also have to know about different payment mechanisms. Some of our divisions are focused on specific types of healthcare, such as oncology. These divisions supply members with knowledge that we've accumulated through serving other members ?information about their condition and treatment, as well as an idea of what may happen and how they may feel. We employ a full-time doctor, and constantly revise our packages in terms of changing medical needs, products and legislation.

We care.

Our primary objective is ensuring the health of our members, and showing humane concern underpins everything we do at Cape Medical Plan. A baby deprived of human contact is at a health disadvantage. A patient who is never touched or smiled at recovers more slowly than one who is. Caring supports health; not caring can be a health risk. And that is the origin of our commitment to all our members: "We care."

September is heart awareness month, dedicated to creating awareness and preventing heart disease in South Africans.

Prevalence and prevention

According to the Heart and Stroke Foundation SA, as many as one in three men and one in four women will have a heart condition before the age of 60. But often there are small changes in lifestyle that are easy to implement and will literally mean the difference between life and death.

What is a heart attack?

A heart attack happens when arteries become too narrow and fatty deposits build up on the inside of your artery walls. This condition, known as atherosclerosis, eventually blocks the flow of blood to your heart, depriving it of oxygen. The severity of the heart attack depends on the amount of damage caused by this lack of oxygen.

"A heart attack seems like a sudden, dramatic event, but actually the fatty deposits build up in your arteries over many years," says Rone Murray, Clicks National Clinic Services Manager. "That is why we are calling on all South Africans to have their cholesterol and blood pressure checked during Heart Awareness Month. There are no visible symptoms when their levels are raised, so it is important to have regular checkups."

How do you know if you are having a heart attack?

The symptoms for men and women can be very different. Many men report a feeling of tightness or crushing pain in the chest. It can feel a bit like indigestion, spreading to your shoulders, arms, neck and jaw, and may last for more than 15 minutes. You may also experience sweating, sickness, faintness and shortness of breath, along with a quick, weak pulse.

Women suffering a heart attack experience a wide range of symptoms, including an uneasy feeling in the chest, abdominal pain, a fluttering heartbeat, shortness of breath, fatigue, nausea, dizziness and/or fainting, and swollen feet.

Preventing heart disease

Prevention is always better than cure, and there are a number of things that you can do to prevent heart disease. Eating a healthy, balanced diet, low in saturated fat; getting regular exercise; reducing stress; quitting smoking and maintaining a healthy body weight can all help to prevent atherosclerosis.

Clicks's new lifestyle management programme, Health Tracker, together with regular blood pressure and cholesterol tests at the Clicks Clinic, can help to keep you healthy. Visit www.clicks.co.za or phone 0860 254 257 to locate your nearest Clicks Pharmacy.

Whether it? because of a quarrel with a loved one, an injustice at the office, or yet another traffic jam, anger is an emotion familiar to us all. Most of us experience it at least once a day, ranging in intensity from mild annoyance to complete rage. Anger can be a healthy emotion that helps us to express our feelings and serves as an outlet for our frustrations. However, when it begins to run rampant and control your life, it can also be a dangerous hazard to your health. Frequent bouts of anger have been proven to contribute to the early onset of heart disease, and people who become angry regularly are five times more at risk than those who try to remain calmer.

What triggers anger in us?

Anger may be triggered by many different things, ranging from memories to situational occurrences. Certain types of personalities are also more prone to outbursts of anger than others. Type A personalities tend to be more anxious, highly-strung and driven, and are subsequently more prone to anger than other personality types. In contrast, Type B personalities tend to be more laid-back and calm, and are slower to become angry. Knowing your personality, level of tolerance and the things that trigger your anger regularly may help you manage your anger more effectively.

What are the physical symptoms of anger?

The physical symptoms of anger include the following:

• An increased heart rate
• A headache and clenched jaw
• Dizziness and shakiness
• A flushed feeling around the neck and face
• Clammy palms

Why is anger management so important?

There are different ways in which people express their anger. The healthiest of these is an assertive expression that lacks aggression, but deals with the root of the anger. Alternatively, people may choose to suppress or aggressively express their anger. Either of the last two methods can contribute negatively to your health by causing overt stress and strain on your body. By learning how to manage your anger more effectively, you can reduce this stress, which in turn reduces your risk of heart disease.

7 ways to manage your anger

1. Keep an anger diary.

An anger diary can help you to identify the situations or occurrences that make you angry. By making a note of the level of anger you are experiencing, and the situation that prompted it, you make yourself more aware of what causes you to become angry.

2. Be aware of your triggers.

The anger diary helps to identify your triggers, and then it is up to you to try and notice them in your everyday environment before you feel yourself becoming angry.

3. Learn to spot the warning signs.

Take note of the physical or emotional symptoms you may experience when becoming angry. The sooner you spot them in a situation, the sooner you will be able to make a concerted effort to manage your anger in a healthy way, before it gets out of control.

4. Start to change the way you think.

Acknowledging that nobody is perfect, and that everyone makes mistakes, is an enormous step towards managing your anger. It? easy to feel frustrated with others or ourselves when we expect everything to be perfect. Learn to relax, and take joy in the imperfections in life, because they will always be there.

5. Be assertive, not aggressive.

Managing your anger doesn? mean backing down and being a doormat. Make a concerted effort to express your displeasure or anger in an assertive manner, clearly expressing why you feel the way you do; and try to see both sides of a conflict from an unbiased perspective. It? also important to be willing to compromise, and to approach any conflict with consideration and politeness towards others.

6. Try to find alternative solutions to the things that anger you.

If you find that certain things make you angrier than others, try to find peaceful solutions to them. For instance, if traffic makes you irate, try leaving home a little bit earlier each morning. Try to take some time for yourself each day, and do an activity that relaxes you, and allows you some escape from your daily stress.

7. Take control of your anger.

Learn to take control of your anger and release your tension. Whether you count to ten before engaging in a conflict, or try to see the humour in the situation, it? important to acknowledge that you control your anger, and that it doesn? control you.

We're going to be holding a few breakfasts for our members during August and September, to share information with you about changes in the healthcare system and how this might impact on products and medical aid in general. There will be guest speakers, as well as an opportunity to have your blood pressure, glucose levels and BMI checked ?this is good news for those of you who've run out of medical savings or are on a hospital plan only. Keep watching for details of the first breakfast, to be held on 26 August.

If you visit the Cape Medical Plan website at www.cmp.co.za, you may notice that we have made a few changes, both functional and visual. Please help us by letting us know of any problems you encounter while using the site, so that we can fix them as quickly as possible, and make your online experience even better.

You can email a description of the problem to customers@cmp.co.za or call us at 021 937 8300 or 0860 102 930. The more information you provide (what page you were on, what link you'd clicked, what happened, etc.) the sooner we'll be able to resolve the issue. Thank you in advance for your help!

• Medical Case Management - 0860 100 512
• Customer Care - 0860 102 930
• Sales - 0860 102 344

To help you plan and take control of your day-to-day medical expenses, we are continuing with our series on medicine pricing.

This month we compare the prices of several therapeutic-equivalent drugs used to treat stomach complaints such as diarrhoea and Irritable Bowel Syndrome. (Therapeutic-equivalent drugs are those that contain the same active ingredients and exhibit largely the same effects.)

In the first table, we compare the prices of different versions of loperamide (2mg, 6 tablets), used to treat diarrhoea.

In the next table you can see a comparison of different brands of hyoscine butylbromide (10 tablets), prescribed for the relief of bloating and stomach cramps.