With significant improvements in technology, lifestyle and healthcare options over recent decades, the simple truth is that people are living much longer than our predecessors did. Just look at our oldest member, Mrs Blaser, featured in this issue of Elixir.

Our population is on the steady increase with little sign of slowing down, with an ageing population as a result. So what, you ask?

It stands to reason that as we age, so too do our bodies and their natural defences. Our immune systems aren't what they used to be, our bones become weaker and general aches and pains are the order of the day. Which begs the question - is an extended life expectancy a gift or a curse?

A recent study by KPMG South Africa has shown that South Africa is well aware of the challenges created by our ageing population. Population specialists have gone as far as to predict a worldwide increase in the number of retired elderly people and a decline in the number of young adults able to support them.

It is thus vital to look after yourself as you age and be able to identify when a day-to-day niggle becomes a medical concern.

Breathing with no air

Respiratory problems in particular are known to plague senior citizens. And while coughing or shortness of breath is sometimes just our natural defences kicking in, it's important to know when to stop reaching for the cough syrup and pick up the phone to your doctor.

For various reasons - including the loss of elasticity in our lungs, shrinking airways and weakened chest muscles - the total flow of air in and out of our lungs decreases as we get older. This, coupled with smoking, exposure to pollution and various other ailments, makes the elderly more susceptible to respiratory problems.

Persistent coughs, wheezing and difficulty breathing are all common respiratory symptoms - sometimes caused merely by overexertion, and nothing to worry about. Severe or frequent symptoms, however, might be early warning signs of more serious health problems like chronic obstructive pulmonary disease (COPD), asthma, obstructive sleep apnea, pulmonary fibrosis, pulmonary thromboembolism or aspiration.

Get help when

• A cough persists for more than three to four weeks. Early medical attention could lead to early diagnosis of more serious conditions like cancer, pneumonia or heart failure.
• Wheezing persists for no apparent reason. Although a cold, asthma and post-nasal drips are all common contributors, wheezing can also be an early symptom of bronchitis or cardiac asthma.
• You have prolonged difficulty breathing. Unless you're out of breath from running up the stairs, laboured breathing could be the onset of heart disease, asthma or lung problems including COPD.

Breathe easy

Keep your lungs in optimal shape with these tips and exercises:

• Alternate between slow, deep breaths and short, fast breaths for five minutes a day - sure to get the blood pumping.
• It is also advisable to take part in 30 minutes of moderate cardio-vascular exercise a day - walking, running, cycling and swimming are all good examples.
• Avoid inhaling dangerous fumes like car emissions, cigarette smoke, aerosols and household chemicals.

Thank you to members who supplied us with email addresses, telephone and ID numbers on request. Our database has grown substantially - we now have 85% of your email addresses and 90% of your cell phone numbers, with reduced administration and postage as a result. Please remember to keep us updated when your details change, or else the accuracy of this information becomes invalid.

Morning exercises, gardening, sewing and cooking, along with a healthy diet of fruit and vegetables (and not a chemical in sight!) appear to be the key to longevity. So says Mrs Margherita Blaser, who, at the ripe old age of 105, is Cape Medical Plan's oldest member.

We paid her a visit to take a few welcome pages out of her book.

Mrs Blaser joined Cape Medical Plan in 1963. A loyal member who last saw a doctor more than 40 years ago, she prefers natural remedies, keeps no medication in her house, uses only eye drops occasionally and is otherwise fit as a fiddle!

"The last time I went to a doctor was when I was 60," she boasts. "I don't actually have a doctor," she admits. After being prescribed an excessive quantity of tablets for arthritis, and not improving, she consulted a naturopath who put her on a strict diet with limited acid intake. She's never looked back.

"My first operation ever was at the age of 104 when I had two cataract operations," she says. "No problems," she continues - "an absolute pleasure".

Her secret? Healthy lifestyle choices from the outset, it seems. Mrs Blaser was born to Italian parents in 1904 and grew up on a wholesome Mediterranean diet. She married in 1931 and went on to have four children, who in turn gave her seven grandchildren and one great-grandchild.

She has never tasted Coke, stopped ingesting caffeine in her 60s, eats a strict diet of fruit and vegetables (no meat or dairy), and does not touch alcohol. "I also never watch TV - there's only rubbish on and it wastes time," she says. Listening to the radio is Mrs Blaser's drug of choice.

Keeping active is also on Mrs Blaser's daily agenda. She's lived in the same house for 66 years and takes care of herself and her house to this day. She employs a domestic helper every fortnight, as well as a gardener to help her with the heavy lifting involved in maintaining her pride and joy - her garden.

At 105, Mrs Blaser looks remarkable for her age. Not surprisingly, she has a refreshing mind-overmatter philosophy about that too: "Relax your scalp and don't screw up your face. Muscles form habits which result in wrinkles," she says.

So the secret is out! We at Cape Medical Plan wish Mrs Blaser well and look forward to many more healthy years together as her medical scheme of choice.

Cape Gate Medi-Clinic, the latest private hospital offering from the Medi-Clinic group, has opened its doors to the public.

Fully operational since 8 February, the new 140-bed hospital is situated next to the Cape Gate shopping complex in Brackenfell, north of Cape Town, and offers clients impressive amenities including:

• six theatres
• 200 parking bays
• comprehensive diagnostic facilities like pathology and radiology
• facilities for specialist nursing care, including adult and neonatal critical care nursing units
• specialised treatment facilities, including a gastroscopy unit
• a 24-hour emergency centre

In addition, 25 full-time supporting specialists are based at the Medi-Clinic to deliver specialist services to the hospital and the 24-hour emergency centre. These services include anaesthesiology, ear nose and throat surgery, gynaecology and obstetrics, general surgery, internal medicine, maxillofacial surgery, neonatology, neurosurgery, orthopaedic surgery, paediatrics, pathology, psychiatry, radiology, spinal surgery, thoracic surgery, urology, and vascular surgery.

The emergency centre is also staffed by experienced trauma doctors and nurses, with an ER24 ambulance service using the hospital as a base and on permanent standby.

Sister hospitals in the vicinity of Cape Gate are the Durbanville Medi-Clinic, Louis Leipoldt Medi-Clinic and Panorama Medi-Clinic.

Cape Gate Medi-Clinic can be contacted at 021 983 5600.

Remember to pay your monthly member fees within three days of the due date. If you can't pay, contact us to make the necessary arrangements. According to the Medical Schemes Act, we reserve the right to resign members who withhold payment without notification.

It's happened again. One or two bouts of flu and your medical savings are completely depleted due to the high cost of the medication prescribed by your doctor. Sound familiar?

Enter generic medicine. For most brand-name drugs, a generic is available under a different name. It contains exactly the same ingredients, but costs significantly fewer rands. Why then doesn't everyone use generics if it's that cut and dried? Simply put, doctors and pharmacists rarely dispense this valuable information, resulting in you probably being none the wiser and simply doing as you're told.

Sky high

Reports have indicated that brand-name drugs have soared in price over recent years, especially ahead of anticipated market reforms. In some instances drug prices have more than doubled between 2000 and 2008, with some jumping by as much as 1 000%.

These high prices are passed down to consumers - you - and in turn to your medical scheme - us. As a result, medical schemes have come under increasing pressure to contain costs without compromising quality of care.

Chronic case

Cape Medical Plan would like to remind you about the Medicines and Related Substances Act that makes provision for generic substitution. In the interest of reducing costs and maximising your medical benefits, we advise you to make an educated switch to generic medicines where possible and furthermore embrace our stance on generic substitution.

To this end, many schemes have deployed designated service providers and formularies for low-end products. At Cape Medical Plan, we manage our chronic benefits as carefully as possible using reference pricing - the maximum rand value that a scheme pays for a particular class of drug.

This price is determined by available generic medication and therapeutic equivalent drugs and chosen to specifically reduce any co-payments on your part.

In the future, please remember that you're completely within your rights to ask your doctor or pharmacist for a generic substitution. Rest assured that the quality of generic medicines is not in any way sub-standard to their brand-name counterparts.

See our medicine pricing guide, featured every other month at the end of Elixir, for examples of how generics compare in price to brandname medicines.

Your questions answered

I have just been diagnosed with a chronic condition. How do I access the chronic medicine benefit?

If your doctor starts you on chronic medicine, always ask him to prescribe a generic medication in order to avoid a co-payment. Then request a chronic medicine application form from us for your doctor to complete, and return it to us via fax, email or post.

I have registered my chronic condition. What procedure must I follow if my doctor wishes to change my medication at a follow-up consultation?

Take another chronic medicine application form and the Cape Medical Plan formulary to your next doctor's visit. A copy of our formulary for your registered condition is available on request. Again, return the completed application form to us. You will be able to obtain your chronic medicine at your pharmacy after two working days.

Why has my benefit for some chronic medicines decreased in 2010?

The pharmaceutical industry is a highly competitive market. Over the last two years, many manufacturers have announced permanent price reductions in order to secure a greater market share. At many medical schemes, chronic medicine subsidies change during the year in response to continual medicine price fluctuations. Cape Medical Plan tries to keep chronic medicine subsidies stable throughout the year so that changes are limited to the beginning of the benefit year where possible.

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

Prolong the life of your medical scheme funds by asking your doctor or pharmacist about generic medicines. By law you are entitled to the option of a medical generic - they contain exactly the same constituents as the original, but cost far less.

In the first table, we look at prices of Felodipine (5mg, 30 tablets), a beta blocker used to treat hypertension.

Next, we look at the prices of Bisoprolol (10mg, 30 tablets), also a beta blocker.

In the final table we compare generic prices for Atorvastatin (20mg, 30 tablets), used to treat and lower cholesterol.

Note: All chronic medication will be substituted with suitable generics according to formularies, protocols and reference pricing wherever possible. No need to panic - this is simply to ensure effective cost management on your behalf.