A key new staff member: Dr Grant Ward
"A medical aid is as good as the health of its members," says Grant Ward, Cape Medical Plan's new resident medical doctor.
Grant's main task is to provide the fund with a professional medical opinion on the health of each prospective member. This opinion guides the fund in assessing risk and allocating cost. Under South African law, medical plans may not deny anyone membership; however, they may exclude or put a higher price on specific risks. This is critical to the health of the scheme, and allows for the careful use of members' accumulated funds.
Rising medical costs are causing people to shop for better deals - Grant explains that this means CMP is receiving numerous membership applications from people whose health records are unknown. In applying, they may or may not declare conditions that could represent major future costs to CMP; in some cases, the applicants themselves may not even know that these conditions exist, and so a qualified medical opinion is vital.
Grant insists that he is not a gatekeeper: "We're not just talking about exclusions." Managing risk may involve different allocations of cost between the plan and a new member, or a trial period in which the new member builds up a safety net of savings instead.
Illness is inevitable, but in order to protect yourself from its effects you must know that you have it, what it is and how to avert its worst effects. For human beings this is common sense; for medical aid plans it is good management. CMP has a responsibility to balance the needs of the individual and the financial health of the plan.
CMP differs from many other funds in that we place health, rather than administrative convenience, at the centre of our operations. At CMP, your point of contact is not a call centre operator, but a qualified nurse, medically informed and compassionate. Grant's appointment takes this ethos a step further.
The young doctor recently returned to Cape Town, his home city, from a working stint in the United Kingdom. Asked why CMP chose him, he smiles, and parodying a dating advertisement, says: "I have an outgoing personality. I balance diplomacy and toughness. And I have organisational skills." Watching him in action reveals professionalism and consideration; Grant is an unassuming man, with a knack of getting straight to the point